scholarly journals Pure Mucinous Breast Carcinoma with Micropapillary Pattern (MUMPC): A Case Report

2019 ◽  
Vol 12 (2) ◽  
pp. 554-559
Author(s):  
Yuka Asano ◽  
Shinichiro Kashiwagi ◽  
Mizuki Nagamori ◽  
Sayaka Tanaka ◽  
Yuko Kuwae ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Left Breast ◽  
World Health ◽  
Histopathological Diagnosis ◽  
Axillary Lymph ◽  
Invasive Micropapillary Carcinoma ◽  
Outer Quadrant ◽  
Atypical Cells ◽  
Micropapillary Pattern ◽  
Mucinous Breast Carcinoma

Pure mucinous breast carcinoma with micropapillary pattern (MUMPC) was proposed as a new histopathological variant of pure mucinous carcinoma (PMC) with tumor cells forming a micropapillary architecture. The Classification of Tumours of the Breast by the World Health Organization, however, does not differentiate MUMPC as a distinct subtype. There is currently no consensus whether tumors that exhibit these features are classified as PMC or invasive micropapillary carcinoma (IMPC) with associated mucin production. A 45-year-old woman was examined for a tumor in her left breast. Upon physical examination, an elastic hard mass of around 5 cm along with accompanying skin flare and ulceration was palpated in the upper outer quadrant of the left breast. Mammary ultrasonography revealed a clearly marginated hypoechoic tumor of 55.0 × 46.9 × 37.0 mm in size in the upper outer quadrant of the left breast. A vacuum-assisted biopsy (VAB) was performed in the same site and histopathological diagnosis of PMC was made. Contrast-enhanced magnetic resonance imaging (MRI) showed a T1W1 low-intensity signal and a T2W1 high-intensity signal at the primary focus, ring enhancement of the tumor margin, and stranding enhancement inside the tumor. A preoperative diagnosis of left breast cancer (PMC), cT4bN1M0, stage IIIB, luminal B-like was made. We performed a simple mastectomy with axillary lymph node dissection. A 55.0 × 48.1 × 37.1 mm tumor with the gelatinous cut surface was excised. Histopathological examination of the excised specimen revealed mucin lake formation in the tumor containing clusters of atypical cells. The atypical cells showed swollen, irregular nuclei and a papillary growth pattern that lead to the diagnosis of MUMPC.

scholarly journals The Role of Postmastectomy Radiotherapy in Locally Advanced Breast Cancer After Pathological Complete Response to Neoadjuvant Chemotherapy

ONCOLOGY ◽  
2021 ◽  
pp. 139-143
Author(s):  
Christian Haydeé Flores-Balcázar ◽  
Francisco Javier Castro-Alonso ◽  
Tania Patricia Hernández-Barragán ◽  
Jesús Delgado-de la Mora ◽  
Antonio Daidone ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Neoadjuvant Treatment ◽  
Left Breast ◽  
Tumor Board ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Outer Quadrant ◽  
Normal Morphology ◽  
Axillary Nodes

A previously healthy woman, aged 32 years, presented to the oncology clinic with a 6-month history of left-breast tumor, mastalgia, and swollen axillary nodes. Physical examination was relevant for a 6-cm palpable mass in the upper outer quadrant of the left breast and an ipsilateral 2-cm, nonfixed axillary lymph node. Mammography showed a 1-cm mass in the upper outer quadrant, a 5.2-cm mass in the lower outer quadrant, and enlarged pathologic lymph nodes (BI-RADS category 5 disease). Breast ultrasound revealed 3 axillary lymph nodes with cortical thickening and loss of normal morphology (the largest with a 2.6-cm length in the long axis) (Figure 1A-B). The breast's core biopsy revealed a grade 3 apocrine invasive carcinoma with lymphovascular invasion; immunohistochemistry testing showed HER2-negative, hormone receptor-negative disease (estrogen receptor, 0%; progesterone receptor, 0%; HER2-negative, Ki67, 50%) (Figure 2A-B). A fine-needle aspiration biopsy of the axillary lymph nodes showed invasive breast carcinoma as well. Bone scintigraphy and a chest/abdomen CT scan ruled out metastatic disease. Upon initial diagnosis, clinical stage was deemed as cT3N1M0 (American Joint Committee on Cancer 8th edition: anatomic stage IIIA, clinical prognostic stage IIIC). After a multidisciplinary tumor board discussion, the patient underwent neoadjuvant chemotherapy with weekly paclitaxel, followed by 4 cycles of dosedense doxorubicin plus cyclophosphamide. After completing neoadjuvant treatment, clinical examination was relevant for a residual 1-cm palpable left breast mass and no palpable axillary nodes. Mammography and breast ultrasound showed a 77% partial response in the primary tumors, and axillary nodes with normal morphology and size (Figure 1C-D). Due to multicentric tumor disease, breast-conserving surgery would not confer satisfactory cosmetic results on her, and a modifi ed radical mastectomy with intraoperative sentinel lymph node biopsy (and second-stage breast reconstruction) was planned. However, during surgery, the surgeons failed to identify the mapped lymph node, and level I-III axillary lymph node dissection was performed. The pathology report described complete pathological response: Miller and Payne criteria grade 5 response with the absence of malignant cells within the mastectomy specimen and in 24 lymph nodes (Figure 2C-E). Pathological staging after neoadjuvant treatment concluded ypT0N0M0 disease. Subsequent treatment for this patient was discussed in another tumor board.

scholarly journals Sonographic Features of Pure Mucinous Brelast Carcinoma With Micropapillary Pattern

2021 ◽  
Vol 11 ◽  
Author(s):  
Wu Zhou ◽  
Yong-Zhong Li ◽  
Li-Min Gao ◽  
Di-Ming Cai
Keyword(s):  
Lymph Node ◽  
Breast Carcinoma ◽  
Lymph Node Metastasis ◽  
Tumor Size ◽  
Invasive Growth ◽  
Acoustic Feature ◽  
Node Metastasis ◽  
Missed Diagnosis ◽  
Micropapillary Pattern ◽  
Mucinous Breast Carcinoma

ObjectivePrevious studies have mostly discussed the clinical manifestations and prognosis of mucinous breast carcinoma with a micropapillary pattern. The purposes of this study were to investigate the sonographic features of pure mucinous breast carcinoma with micropapillary pattern (MUMPC) and to identify the role of ultrasound in the differential diagnosis between MUMPC and conventional pure mucinous breast carcinoma (cPMBC).Materials and MethodsWe obtained written informed consent from all patients, and the Ethics Committee of West China Hospital approved this retrospective study. The study was conducted between May and August 2020. We enrolled 133 patients with 133 breast lesions confirmed as mucinous breast carcinoma (MBC) histopathologically between January 2014 and January 2020.We retrospectively assessed sonographic features (margin, shape, internal echogenicity, calcification, posterior acoustic feature, invasive growth, blood flow grade, and rate of missed diagnosis) and clinical characteristics (age, tumor size, tumor texture, initial symptom, and lymph node metastasis). Bivariable analyses were performed using SPSS version 19.0.ResultsThe 133 lesions included 11 MUMPCs, 65 cPMBCs, and 57 mixed MBCs (MMBCs). There were significant differences in margin, shape, calcification, posterior acoustic feature, invasive growth, rate of missed diagnosis, average tumor size, and lymph node metastasis among the three groups (p < 0.05). The subsequent pairwise comparisons showed that there were significant differences in lymph node metastasis, margin, and invasive growth between MUMPC and cPMBC (p < 0.05). In patients aged >45 years, there was a significant difference in tumor size among the three groups (p = 0.045), and paired comparison showed that the average tumor size in the cPMBC group was larger than that in the MMBC group (p = 0.014).ConclusionMUMPC showed a non-circumscribed margin and invasive growth more frequently than cPMBC did. Lymphatic metastasis was more likely to occur in MUMPC than cPMBC. Ultrasound is helpful to distinguish MUMPC from cPMBC.

scholarly journals A Case of Pure Mucinous Breast Carcinoma in a 25-Year-Old Female Who Showed Complete Pathological Response to Neoadjuvant Chemotherapy despite Poor Clinical Response

Breast Care ◽  
2019 ◽  
Vol 15 (5) ◽  
pp. 538-542
Author(s):  
Pei Du ◽  
Chunjie Hou ◽  
Jinglan Tang ◽  
Ying Liu ◽  
Qiaohong Hu ◽  
...  
Keyword(s):  
Lymph Node ◽  
Breast Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Pathological Response ◽  
Maximum Diameter ◽  
Axillary Lymph ◽  
Histologic Subtype ◽  
Response To Chemotherapy ◽  
Response To Neoadjuvant Chemotherapy ◽  
Mucinous Breast Carcinoma

Introduction: Mucinous breast carcinoma is a rare histologic subtype of primary breast cancers accounting for 1–6%. It is a rare histological variant in young patients and usually presents without lymph node involvement, and its pathological response to neoadjuvant chemotherapy is rarely reported. Case Presentation: Pure mucinous breast carcinoma in a 25-year-old female was treated with neoadjuvant chemotherapy every 3 weeks for 8 cycles. After the fifth cycle, the mass size showed no change. We performed modified radical mastectomy in the left breast and axillary lymph node clearance. However, the pathological report showed a complete elimination of both the breast tumor and axillary lymph nodes, which were filled with mucus but did not contain malignant cells Discussion: Chemotherapy was profoundly effective against the tumor cells, but ineffective against large amounts of extracellular mucus. Even though the cancer cells were sensitive to chemotherapy, the volume of mucinous cancer couldnot be reduced. Conclusion: In summary, the evaluation criteria of tumor response to chemotherapy based on maximum diameter only should be considered insufficient for mucinous carcinoma.

scholarly journals Metaplastic breast carcinoma with chondrosarcomatous differentiation: an unusual disease with a worse prognosis

2020 ◽  
Vol 7 (4) ◽  
pp. 1277
Author(s):  
Samuel Lalhruaizela ◽  
Bhupendra Mehra
Keyword(s):  
Breast Carcinoma ◽  
World Health ◽  
Metaplastic Carcinoma ◽  
Axillary Lymph ◽  
Breast Cancers ◽  
Duct Carcinoma ◽  
Increased Risk ◽  
Chondroid Metaplasia ◽  
Worse Prognosis ◽  
Metaplastic Breast Carcinoma

Metaplastic breast carcinoma (MBC) has an incidence of <1% of all breast cancers and MBC with chondrosarcomatous differentiation is even more rare, <0.1% of all cases. The World Health Organization have classified MBC into pure epithelial-type and mixed epithelial and mesenchymal type. The epithelial-type MBC is sub-classified into squamous cell carcinoma, adenosquamous carcinoma and adenocarcinoma with spindle cell differentiation; mixed type MBC is sub-classified into carcinosarcoma and carcinoma with osseous and chondroid metaplasia. Metaplastic carcinomas of the breast are characterized by large tumour size and rapid  growth, and they are usually estrogen receptor, progesterone receptor, and HER2/neu negative and tend to have a worse prognosis than other triple negative breast cancers. There is a noteworthy increased risk of tumour recurrence and a worse prognosis with MBC compared with invasive lobular carcinoma and infiltrating duct carcinoma. We report a case of metaplastic carcinoma with extensive chondroid differentiation that is chondrosarcoma and chondroid metaplasia along with classic infiltrating duct carcinoma with involvement of ipsilateral axillary lymph nodes.

scholarly journals Clinical Assessment of 324 Breast Cancer Cases in Two Centers Between the Years of 1992 and 2002

2003 ◽  
Vol 46 (4) ◽  
pp. 195-199
Author(s):  
Ali Borazan ◽  
Hasan Üstün ◽  
Faruk Aksoy ◽  
Celalettin Vatansev ◽  
Zafer Cantürk ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Systemic Chemotherapy ◽  
Ductal Carcinoma ◽  
Estrogen Receptor Status ◽  
Left Breast ◽  
Axillary Lymph Node Metastasis ◽  
University Hospital ◽  
Histopathological Diagnosis ◽  
Axillary Lymph

The records of the 324 patients with breast cancer; diagnosed and followed in two different University Hospital between years of January 1992 and January 2002 were reviewed retrospectively. The median age of the patients was 49.0±12.5 years, with the range of 18 and 90 years. The most frequently seen age interval of the patients was 40 and 49 years. The most frequently seen symptom and physical examination finding of the patients were breast mass. Breast cancer was diagnosed in 324 women, 173 in the left breast and 151 in the right breast. At the hospital admission percentages of the patients’ disease stages were as follows: I (2.8 %), IIA (30.0 %), IIB (24.0 %), IIIA (19.8 %), IIIB (11.4) and IV (12.0 %). The most frequently seen histopathological diagnosis was infiltrative ductal carcinoma (84.4 %). Axillary lymph node metastasis was found in 61.7 % of the patients. Primary therapeutic options and percentages were surgical therapy (78.5 %), systemic chemotherapy (17.5 %) and radiotherapy (4 %). Systemic chemotherapy was given to 81.2 % of the patients. From the files, estrogen receptor status was known in 311 and positive in 128 (41.2 %) of them. Tamoxifen was given patients who had positive estrogen receptor. The five-year survival rate of the patients was calculated as 75.9 %.

Tubulopapillary Carcinoma: An Aggressive Variant of Invasive Breast Carcinoma With a Micropapillary DCIS-Like Morphology

2019 ◽  
Vol 28 (5) ◽  
pp. 536-540
Author(s):  
Claudio Guerrieri ◽  
Rachel Hudacko
Keyword(s):  
Breast Carcinoma ◽  
Invasive Carcinoma ◽  
Ductal Carcinoma ◽  
Myoepithelial Cells ◽  
Invasive Breast Carcinoma ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Invasive Micropapillary Carcinoma ◽  
Serous Papillary Carcinoma

Tubulopapillary carcinoma is a recently described variant of breast carcinoma characterized by a proliferation of elongated and anastomosing tubular glands exhibiting intraluminal micropapillary and sometimes papillary epithelial projections. We have recently encountered a patient with invasive breast carcinoma displaying a prominent tubulopapillary component. The histomorphology in our case had an uncanny resemblance to micropapillary ductal carcinoma in situ, but the invasive nature of the glands was confirmed not only by the lack of myoepithelial cells but also by the presence of identical metastatic foci within ipsilateral axillary lymph nodes. This case was made all the more intricate by the simultaneous presence of invasive micropapillary carcinoma in the opposite breast and a carcinosarcoma of the uterus with a serous papillary carcinoma component. As noted in the only prior report on tubulopapillary carcinoma of the breast, our case confirms the aggressive nature of this form of invasive carcinoma, the histological features of which appear to be easily identifiable and reproducible.

scholarly journals Evaluation of Hormone Receptors Status in Breast Carcinoma

2019 ◽  
Vol 10 (2) ◽  
pp. 70-73
Author(s):  
Kazi Nishat Ara Begum ◽  
Abdul Khaleque Akond ◽  
Naila Huq ◽  
Nazneen Naher Aymon ◽  
Fahmida Huq
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Lymph Nodes ◽  
Hormone Receptor ◽  
Hormone Receptor Status ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Middle Aged ◽  
Outer Quadrant ◽  
Receptor Status

Background & objective: The importance of establishing hormone receptor status of tumors for the treatment of women with hormone receptor-positive breast cancer is often emphasized. It is critical to evaluate hormone receptor status when considering response to endocrine therapy. The present study was intended to evaluate the usefulness of hormone receptor status in breast carcinoma. Materials & Methods: The present study was conducted in the Department of Pathology, Dhaka Medical College, Dhaka over a period 12 months from July 2009 to June 2010. A total of 30 histopathologically diagnosed cases of breast tumors who were also subjected to immunohistochemical (IHC) test for ER, PR status and HER-2/neu were consecutively included in the study. Patients who have already been treated for malignancy or who had a history of receiving radiotherapy were excluded. Result: Age distributions shows that 40% of the patients were early middle-aged (30-40 years), 30% middle-aged and the rest were either < 30 years or >50 years old. Left breast was involved more often (56.7%) than the right breast (43.3%). The predominant location was upper outer quadrant (43.3%), followed by upper inner quadrant (20%), lower outer quadrant (20%), lower inner quadrant (10%) and central (6.7%). Over half (53.3%) of the tumors were < 5 cm and the rest 5 cm or more. Nearly half (46.7%) of the tumors were moderately differentiated, 36.6% well-differentiated and 16.7% poorly differentiated. In majority (83.3%) of the cases lymph-nodes (axillary lymph nodes) were involved. Based on estrogen and progesterone receptor status, over half (53.3%) of the tumors were ER and PR positive and 40% were Her2/neu overexpressed. Conclusion: The study concluded that half of the Bangladeshi breast cancer patients are ER and PR positive and two in every five cases are Her2/neu overexpressed. J Shaheed Suhrawardy Med Coll, December 2018, Vol.10(2); 70-73

scholarly journals Tubercular Breast Lesion A Great Mimicker of Carcinoma Breast

2013 ◽  
Vol 3 (1) ◽  
pp. 99-102 ◽  
Author(s):  
BNK Kumar ◽  
Bhargav Pandya ◽  
D Das ◽  
PN Sheeramulu
Keyword(s):  
Breast Carcinoma ◽  
Rare Disease ◽  
Female Patient ◽  
Breast Lesion ◽  
Left Breast ◽  
Breast Abscess ◽  
Outer Quadrant ◽  
Carcinoma Breast ◽  
Breast Tuberculosis ◽  
Multiparous Women

Breast tuberculosis is uncommon entity with confusing clinical, radiological and even microbiological presentation which is often misdiagnosed as breast carcinoma or breast abscess.1 A 28 year old female patient presented with a swelling in outer quadrant of left breast which resembled carcinoma of breast but on ultrasound a hypoechoic lesion was noted which turned out to be tuberculosis on histopathology.Conclusion: Breast tuberculosis (TB) is a rare disease typically affecting young lactating multiparous women and can present either as an abscess or as a unilateral, painless breast mass which can easily be confused with carcinoma.2, 3 Nepalese Journal of Radiology / Vol.3 / No.1 / Issue 4 / Jan-June, 2013 / 99-102 DOI: http://dx.doi.org/10.3126/njr.v3i1.8822

scholarly journals Mucinous Carcinoma of the breast with micropapillary pattern and psammomatous calcification: A case study.

2021 ◽  
Vol 11 (1) ◽  
pp. 1886-1890
Author(s):  
Koushiki Bhattacharjee ◽  
Manna Valiathan
Keyword(s):  
Incidental Finding ◽  
Radical Mastectomy ◽  
Mucinous Carcinoma ◽  
Left Breast ◽  
Psammoma Bodies ◽  
Carcinoma Of The Breast ◽  
Outer Quadrant ◽  
Nulliparous Female ◽  
Micropapillary Pattern

Mucinous carcinoma with a micropapillary pattern is an unusual form of Invasive breast cancer exhibiting dual mucinous and micropapillary differentiation. The present case is of a 47-year-old nulliparous female who presented with an incidental finding of a hard lump in her left breast. Mammography revealed a BIRADS 4 lesion. Modified radical mastectomy was done and the specimen was grossed, revealing a tumor of 3x2.6x2.6 cm in the outer quadrant. Microscopy revealed the tumor having extracellular mucin pools with floating psammoma bodies and focal micropapillary pattern. Four of the twenty-six lymph nodes sampled were found to have tumor deposits. The micropapillary pattern was maintained in the metastatic deposits. Immunohistochemistry revealed ER and PR positivity and Her2Neu negativity. EMA corroborated the findings. It is important to recognize the micropapillary pattern in mucinous carcinomas of the breast as these tumors tend to be more aggressive than pure mucinous breast lesions. 

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