Sonographic Features of Pure Mucinous Brelast Carcinoma With Micropapillary Pattern.

Wu Zhou,Li-Min Gao,Yong-Zhong Li,Di-Ming Cai

doi:10.3389/fonc.2021.644180

Wu Zhou, Li-Min Gao + Show 2 more

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https://doi.org/10.3389/fonc.2021.644180

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Abstract

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.

Highlights

Mucinous breast carcinoma (MBC) is a relatively rare entity of breast neoplasm with a characteristic of abundant extracellular mucin, representing about 1%–4% of all the primary mammary carcinomas and associated with a favorable prognosis [1, 2]
The 133 lesions consisted of 11 MUMPCs, 65 cPMBCs, and 57 mixed MBC (MMBC)
Compared with cPMBC, non-circumscribed margin (Figure 1), irregular shape (Figure 2), invasive growth (Figure 3), and lymph node metastasis occurred more frequently in MUMPC (100% vs. 58.5%, 100% vs. 67.7%, 100% vs. 58.5%, 72.7% vs. 24.6%, respectively, p < 0.05, Table 1)

Summary

Introduction

Mucinous breast carcinoma (MBC) is a relatively rare entity of breast neoplasm with a characteristic of abundant extracellular mucin, representing about 1%–4% of all the primary mammary carcinomas and associated with a favorable prognosis [1, 2]. PMBC consists exclusively of tumor cells responsible for mucoid production, and the mucoid component accounts for >90% of the tumor. In MMBC, 50%–90% is mainly mucinous and admixed with an infiltrating ductal epithelial component [5]. Many investigations have shown that PMBC is an indolent tumor linked with a favorable prognosis, whereas MMBC exhibits a contrasting biological behavior [6, 7]. Ranade et al found that a micropapillary pattern was seen in 60% of lymph-node-positive PMBCs and 14% of lymph-node-negative PMBCs, which indicated that the micropapillary architecture played an important role in the development of lymph node disease [10]. It appears to be important to understand mucinous breast carcinomas with micropapillary pattern (MUMPCs) more profoundly. We retrospectively investigated the sonographic features of MUMPC and identified the role of ultrasound in the differential diagnosis between MUMPC and cPMBC

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Discussion

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