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

Koushiki Bhattacharjee,Manna Valiathan

doi:10.3126/jpn.v11i1.30950

Koushiki Bhattacharjee, Manna Valiathan

Open Access

https://doi.org/10.3126/jpn.v11i1.30950

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Abstract

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.

Highlights

Breast cancer is the most common female cancer worldwide with an estimated 1.67 million new cases in 2012 and represents a quarter (25%) of all cancers.[1]
Mucinous carcinoma of the breast is relatively rare in clinical practice, comprising approximately 4% of all invasive breast cancers, with its incidence in women under 35 years of age being 1%
The difference between the pure and mixed varieties is important as the Pure mucinous breast carcinomas (PMBC) has a much better prognosis compared to Mucinous Micropapillary carcinoma (MUMPC).[8]

Summary

INTRODUCTION

Breast cancer is the most common female cancer worldwide with an estimated 1.67 million new cases in 2012 and represents a quarter (25%) of all cancers.[1]. Mucinous Micropapillary carcinoma (MUMPC) is an unusual variant of the tumor which shows vascular invasion. The difference between the pure and mixed varieties is important as the Pure mucinous breast carcinomas (PMBC) has a much better prognosis compared to MUMPC.[8]. MUMPC has recently been described by various authors[9-12] as an unusual form of invasive breast cancer sharing features of both micropapillary and mucinous tumors. They usually comprise less than 1% of all breast carcinomas and tend to affect the younger individuals as compared to PMBC with median values of 44-55 years.[9,10]. The salient features to label a tumor as MUMPC include: 1. Predominantly mucinous appearance (> 90% mucinous component)

Frequent psammomatous calcifications7

Findings

CONCLUSIONS