Mucinous Breast Cancer Research Articles

The Genomic Landscape of Mucinous Breast Cancer.

Mucinous carcinoma of the breast (MCB) is a rare histologic form of estrogen receptor (ER)-positive/HER2-negative breast cancer (BC) characterized by tumor cells floating in lakes of mucin. We assessed the genomic landscape of 32 MCBs by whole-exome sequencing and/or RNA-sequencing. GATA3 (23.8%), KMT2C (19.0%), and MAP3K1 (14.3%) were the most frequently mutated genes in pure MCBs. In addition, two recurrent but not pathognomonic fusion genes, OAZ1-CSNK1G2 and RFC4-LPP, were detected in 3/31 (9.7%) and 2/31 (6.5%) samples, respectively. Compared with ER-positive/HER2-negative common forms of BC, MCBs displayed lower PIK3CA and TP53 mutation rates and fewer concurrent 1q gains and 16q losses. Clonal decomposition analysis of the mucinous and ductal components independently microdissected from five mixed MCBs revealed that they are clonally related and evolve following clonal selection or parallel evolution. Our findings indicate that MCB represents a genetically distinct ER-positive/HER2-negative form of BC.

Features of differential diagnosis of mucinous and mucinous micropapillary breast cancer

Features of differential diagnosis of mucinous and mucinous micropapillary breast cancer

Omission of Chemotherapy for the Treatment of Mucinous Breast Cancer: A Nationwide Study from the Korean Breast Cancer Society.

PurposeMucinous breast carcinoma (MBC) is a rare type of breast cancer. Although patients with MBC may have a better prognosis than that of patients with invasive ductal carcinoma, many clinicians administer adjuvant chemotherapy regimens similar to those for other breast tumors. Using data from a nationwide clinical database, this study evaluated the significance of adjuvant systemic chemotherapy and whether it can be omitted in MBC patients.MethodsWe included 3,076 patients with a diagnosis of MBC recorded in the Korean Breast Cancer Registry between January 1990 and August 2016. We used the Kaplan-Meier method to analyze breast cancer-specific survival (BCCS) and overall survival (OS). Multivariate analysis was performed using a Cox proportional hazard ratio (HR) model to estimate the adjusted HR for each prognostic factor.ResultsA total of 2,988 MBC patients were enrolled and followed-up for a median of 100 months (range, 2–324 months). Multivariate analysis revealed that axillary lymph node (ALN) metastasis and estrogen receptor (ER) negativity were significant prognostic factors for BCSS. Meanwhile, old age, pathologic tumor stage, and ALN metastasis were significant prognostic factors for OS. Subgroup analysis of ER-positive MBC showed that ALN metastasis was a significant prognostic factor for BCSS. Additionally, old age, pathologic tumor stage, and ALN metastasis were prognostic factors for OS. Ultimately, ALN metastasis was the most statistically significant prognostic factor for MBC. However, chemotherapy had no significant effect on BCSS and OS. The Kaplan-Meier curves of BCSS and OS based on pathologic tumor and nodal stages and age revealed that chemotherapy did not statistically significantly improve prognosis, except for the N3 stage.ConclusionOur large retrospective analysis revealed that adjuvant chemotherapy provided little benefit to improve the prognosis of most ER-positive MBC patients. Therefore, chemotherapy can be omitted in the treatment of most ER-positive MBC.

Tubular and mucinous breast cancer: results of a cohort of 917 patients.

To analyze axillary lymph node involvement (ALNI) rate and survival for mucinous (MC) and tubular (TC) breast carcinomas considered being of very good prognosis and for which an axillary surgical exploration could be questioned. Our multicentric cohort consisted of 21,135 patients with clinically node-negative invasive breast cancer, without neoadjuvant therapy, between 1999 and 2013 in 10 French centers. ALNI rate and survival were analyzed according to patient and tumor characteristics. Our cohort consisted of 672 TC and 245 MC. Patients were older and tumor size greater for MC and pathologic factors were more pejorative. The rate of mastectomies and adjuvant chemotherapy was higher in the MC group. Axillary lymph node status was determined by SLNB alone in 71.2% of patients. ALNI rates were 17.9% and 18% for TC and MC, respectively. ALNI rate was lesser for MC (OR 0.503, p = 0.024) and greater in case of lympho-vascular invasion (OR 5.0, p < 0.0001) and for tumors >10 mm (OR 2.17, p = 0.042). Median follow-up was 58 months. The 5- and 7-year overall survival rates were 97.1% and 95% for TC, respectively; 92.3% and 91.2% for MC ( p = 0.043); 5- and 7-year disease-free survival rates were 97.9% and 97.2% versus 95.2 and 93.6% ( p = 0.041). Lympho-vascular invasion was the only predictive factor for overall survival (hazard ratio [HR] = 2.70)' grade 2 (HR = 10) and HR-negative (HR = 4.9) were the two predictive factors for disease-free survival. This study confirms the need for an axillary exploration for these tumors even for a tumor size <10 mm and a favorable prognosis.

Breast cancer laterality and molecular subtype likely share a common risk factor.

BackgroundTo investigate the epidemiological features of breast cancer laterality and molecular subtypes in southern China.Materials and methodsA total of 2,049 cases who were diagnosed with unilateral breast cancer in the past 5 years were classified based on laterality and molecular subtypes. Molecular subtypes were defined in accordance with the 2013 St. Gallen recommendations.ResultsBreast cancer was more likely to be diagnosed in the left breast than in the right at a rate of around 5%. In the case of invasive carcinomas, the right breast was more commonly affected than the left in young (<40 years old) patients (left-to-right [L:R] ratio 0.80, 95% CI 0.65, 0.98), whereas the opposite trend was found in old (≥40 years old) patients (L:R ratio 1.06, 95% CI 1.02, 1.73). Except for invasive mucinous and invasive medullary breast cancers, the other histological types occurred more frequently on the left side than on the right. In situ cancer with a defined subtype was likely to be diagnosed as luminal B(HER-2+). Except for invasive medullary and invasive nonspecific cancers, other invasive carcinomas with a defined subtype were most likely to be diagnosed as luminal B(HER-2−). The age of ≥40 years was a risk factor for luminal B(HER-2+), and a significant correlation was present between the right breast and luminal B(HER-2+).ConclusionWe explored the risk factors of breast cancer laterality and various molecular subtypes and found that age may be a predictor of breast cancer laterality. We found that age and laterality are the probable risk factors of the luminal B(HER-2+) type of breast cancer. These results provide a basis for the epidemiological characterization of breast cancer.

Predictors for Survival and Distribution of 21-Gene Recurrence Score in Patients With Pure Mucinous Breast Cancer: A SEER Population-Based Retrospective Analysis

BackgroundPure mucinous breast cancer (PMBC) is a rare pathologic type of breast cancer, the prognostic factors of which have not been clearly defined. This study aimed to analyze the prognostic markers and distribution of 21-gene recurrence score (RS) in patients with PMBC. Patients and MethodsUtilizing the Surveillance, Epidemiology, and End Results (SEER) database, a retrospective analysis of PMBC cases was conducted. Multivariate analyses were used to evaluate the indicators for prognosis and the correlations between RS and traditional clinicopathologic characteristics. Disease was subdivided into 4 molecular phenotypes using estrogen receptor (ER) status and tumor grade. ResultsOf the 8048 patients, most had ER-positive and node-negative tumors. Multivariate analysis revealed that molecular phenotype as well as age, race, tumor size, and lymph node status was an independent prognostic factor for patients with PMBC (P < .05). The 5-year breast cancer–specific survival of patients among different phenotypes was significantly different (97.9% for ER-positive and grade I tumor, 96.9% for ER-positive and grade II-III tumor, 96% for ER-negative and grade I tumor, 90.1% for ER-negative and grade II-III tumors, P < .001). The proportions of patients categorized into low, intermediate, and high RS risk group were 64.9%, 31.9%, and 3.2%, respectively. Grade, progesterone receptor status, and age were identified as independent variables associated with RS. ConclusionPMBC had favorable biological features and relatively good prognosis. Molecular phenotype as well as age, race, tumor size, and lymph node status were independent prognostic markers. Furthermore, age, progesterone receptor status, and grade could independently predict RS.

355 (PB-150) - Neo-adjuvant chemotherapy in mucinous breast cancer: Is it of clinical added value?

355 (PB-150) - Neo-adjuvant chemotherapy in mucinous breast cancer: Is it of clinical added value?

Abstract P1-07-29: Clinicopathologic characteristics and prognostic factors of pure mucinous breast cancer

Abstract Background: Mucinous carcinoma of the breast is a uncommon particular type of breast cancer and comprises approximately 4% of all invasive breast cancers. It is charactarized by abundant extracellular mucin production and present a more favorable prognosis than IDC-NOS. Pathologically, mucinous carcinoma is divided into two subtypes : pure and mixed. In this study, we reviewed the clinicopathologic characteristics and prognostic factors of pure mucinous carcinoma. Methods: We reviewed the 23 years cumulative data of pure mucinous breast cancer patients from database of the Breast Cancer Center at ASAN medical center, Korea, between 1989-2011, retrospectively. Total 386 pure mucinous carcinoma cases were reviewed to analyze clinicopathologic characteristics and prognosis. Result: Total of 386 patients with pure mucinous breast cancer were identified. Mean age was 46.7. 149 patients underwent modified radical mastectomy and 236 underwent breast-conserving therapy. The T-stage was T1 in 187 patients, T2 in 178 patients, T3 in 17 patient and T4 in 4 patients. Node negative was 325 and node positive was 61. Estrogen receptor was positive in 342 and negative in 29. Progesterone receptor was positive in 276 and negative in 95. HER-2 was positive in 47 and negative in 273. 152 patients received adjuvant chemotherapy and 240 patients received adjuvant radiotherapy. 351 patients received hormone therapy and among these patients, 231 patients were treated with Tamoxifen alone, 81 were Tamoxifen with ovarian function suppression, 37 were AI only and one patient was ovarian function suppression only. The 5 year disease free survival rate was 93.3%, 5 year cancer specific survival rate was 98.2% and 5 year overall survival rate was 96.6%. Univariate analysis showed that ER status, nodal status and Her2 status were appear to be prognostic factor of Disease free survival rate. Using Cox regression, result of multivariate analysis revealed that only nodal status is the most significant prognostic factor for survival rate. Conclusions: Pure mucinous carcinoma of the breast is a rare subtype with a favorable prognosis. Nodal status rather than ER status, Her2 status are considered to be the most significant prognostic factor of pure mucinos breast cancer. Citation Format: Gwark SC, Lee JW, Lee SB, Sohn G, Kim J, Chung IY, Kim HJ, Ko BS, Son BH, Ahn SH. Clinicopathologic characteristics and prognostic factors of pure mucinous breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-07-29.

Breast Cancer Laterality and Molecular Subtype Likely Share a Common Risk Factor

Background: To investigate the epidemiologic features of breast cancer laterality and molecular subtypes in Southern China, we retrospectively analyzed the clinical data of patients with a definite diagnosis of breast cancer in 2013-2017. Methods: Data for inpatient hospitalization associated with breast cancer were obtained from the Affiliated Hospital of Guangdong Medical University, Guangdong Province, South China. Around 2060 cases who were diagnosed with unilateral breast cancer for the past 5 years were classified based on laterality and molecular subtypes. Molecular subtypes were defined in accordance with the 2013 St. Gallen recommendations. All statistical analyses were performed using Statistical Product and Service Solutions version 21 and Excel version 2010. Results: Breast cancer is more likely to be diagnosed in the left breast than in the right by around 5%. In both in situ and invasive carcinomas, the right breast is more commonly affected than the left in young (<40 years old) patients, whereas the opposite is true for old (≥40 years old) patients. Except for invasive mucinous and invasive medullary breast cancers, other histological types occur more on the left side than on the right. The mean age at diagnosis ranges from 47.6 years for women with luminal B(HER-2 ) tumors to 51.8 years for women with HER-2-overexpressing tumors. In situ cancer is likely to be diagnosed with luminal B(HER-2-). Except for invasive medullary and invasive not specified cancers, other invasive carcinomas are also most likely to be diagnosed as luminal B(HER-2-. The age of ≥40 years is a risk factor for luminal B(HER-2), and a significant correlation is present between the left breast and luminal B(HER-2 ). Conclusion: We explored the risk factors of breast cancer laterality and molecular subtypes and found that age may be a predictor of breast cancer laterality. In the study of molecular subtypes of breast cancer, we analyzed the risk factors of various molecular subtypes. We found that age and laterality are probable risk factors of the luminal B(HER-2 ) type of breast cancer. These results provide a basis for the epidemiological characterization of breast cancer. Funding: Supported by Major application special topics of the science and technology department of Guangdong province, China (No. 2015B010131016) and Science and Technology Planning Project of Guangdong Province, China (No. 2014A020212291). Conflict of interest: No conflict of interest exits in the submission of this manuscript. Ethical approval statement: This research was approved by the Medical Sciences Ethics Committee of the Affiliated Hospital of Guangdong Medical University. All study participants received detailed written information in advance and signed a written informed consent prior to the study. Results of the study will be published as well.

Distribution and Clinical Utility of the 21-gene Recurrence Score in Pure Mucinous Breast Cancer Patients: a case-control study.

The 21-gene recurrence score (RS) is increasingly being used for patients with early stage, hormone receptor-positive, Her-2-negative breast cancer. However, these results are largely from populations with infiltrating ductal carcinoma (IDC). The clinical value of RS testing in mucinous carcinoma has not been well investigated. Pure mucinous breast cancer (PMBC) and paired pure IDC patients who underwent 21-gene RS were retrospectively reviewed and matched with tumor stage and molecular subtype. Clinic-pathological factors, treatment strategies, and RS distribution were compared between the PMBC and IDC patients. A total of 35 PMBC and 70 IDC patients were included. We found that RS was lower in the PMBC as compared with the IDC group: 21.26 vs. 24.40 (P=0.037). Regarding RS categories, PMBC patients had a relatively lower percentage of high RS patients than the IDC group: 8.57% vs. 22.86% (P = 0.048). Multivariate analysis showed that histologic type was an independent factor predicting RS distribution: IDC patients were associated with a higher RS as compared with PMBC patients (OR: 1.27, 95% CI: 1.03-2.13; P=0.014). Among genes in 21-gene RS testing, HER2, STMY3, STK15, and BAG1 were significantly different between the PMBC and IDC groups (P < 0.05). Two patients (5.71%) in the PMBC group, both with high RS, were recommended to receive adjuvant chemotherapy, much lower than patients with IDC (57.14%, P < 0.001). In multivariate analysis, histologic type of IDC was an independent factor for chemotherapy recommendation (OR = 22.00, 95% CI: 4.89-98.97, P<0.001). With a medium follow-up time of 24 months, one IDC patient had ipsilateral axillary lymph nodes recurrence and one PMBC patient had contralateral breast cancer. In conclusion, PMBC patients, mostly classified with low or intermediate RS category, were associated with lower RS as compared with IDC patients. PMBC and IDC had different genes expression patterns. Patients with high RS in the PMBC group might be recommended to receive adjuvant chemotherapy, which deserves further clinical evaluation.

A Case Study on Primary Osteosarcoma of the Breast

Primary osteosarcomas of the breast are very rare neoplasias, accounting for less than 1% of breast carcinomas and 12.5% of breast sarcomas, with only 50 cases reported in the last 50 years. The mechanism of tumorigenesis is not clear, it’s postulated that it is formed from totipotential cells of the stroma. It´s also has been postulated that previous radiotherapy may induce formation of breast sarcoma like ostegenic sarcomas. We report a case of a 93 year old female with a history of left mucinous breast cancer treated with adjuvant chemotherapy and radiotherapy and breast conserving surgery. Five years later, another tumor emerged in the left breast which was diagnosed like osteosarcoma. This case study traces that osteosarcoma of the breast may occur in a patient with previous radiotherapy.

Clinical features and risk factors for recurrence in mucinous breast cancer

Objective: To investigate the clinicopathological characteristic and risk factors for recurrence in different subtypes of mucinous breast cancer(MBC). Methods: Clinical data of 97 MBC patients at Zhejiang Cancer Hospital from August 2005 to November 2012 were retrospectively analyzed. All of patients were divided into 3 subtypes according to the mucinous components in the tumors, named as partial mixed MBC with less than 50% of mucinous components, main mixed MBC where the mucinous component accounted for 50% to 90%, and pure MBC with more than 90% of mucinous components. In this study, 43, 16 and 38 patients were included in partial mixed MBC, main mixed MBC, and pure MBC, respectively. Follow-up was collected by out-patient, in-patient system and phone call. The relationship between different subtypes and clinicopathological significance were analyzed by χ(2) test. Kaplan-Meier curve combined with Log-rank test was used to evaluate the risk factors of relapse free survival(RFS) at 3- and 5-year. Cox proportional hazard regression model was used for multivariate analysis. Results: The median follow-up time was 65 months (range 24-125). Of the 97 patients, 14 patients were relapse or metastasis at the end point. The 3- and 5-year RFS were 90.7% and 85.7%, respectively. Tumor size, number of involved lymph nodes (LN), axillary LN metastasis, TNM stages and p53 mutant status were all related with subtypes of MBC(all of P<0.05). There was no correlation between subtypes of MBC and the other parameters, including age at surgery, estrogen receptor (ER) status, progesterone receptor (PR) status, human epidermal growth factor receptor-2 (HER-2) overexpression, menstruation status, and the relapse of disease(all of P>0.05). Univariate analysis showed menstruation status and TNM stages were associated with the relapse of breast cancer(P<0.05). The patients with menopause and stage Ⅲ-Ⅳ showed significantly shorter RFS time(both of P<0.05). Multivariate Cox proportional hazard regression analysis revealed that tumor size, PR status and postoperative radiotherapy were the independent prognostic factors for the relapse of MBC. Conclusions: Tumor size, status of axillary LN metastasis, TNM stages, and p53 mutation status are differ among different subtypes of MBC. The tumor size (>30 mm), PR status and postoperative radiotherapy are the independent risk factors for recurrence, whereas the proportion of the mucinous component is not associated with relapse in MBC patients.

Tubular and mucinous breast cancer: Can sentinel node biopsy be safely omitted?

Tubular and mucinous breast cancer: Can sentinel node biopsy be safely omitted?

Pure mucinous carcinoma of breast cancer in 56 Tunisian women

BackgroundPure mucinous carcinoma breast cancer (PMBC) is a relatively rare subtype cancer of breast malignancy and associated with favorable prognosis. This retrospective study aims to investigate clinical, pathological features and clinical long-term outcomes. MethodsA retrospective review of 56 patients' files with pure mucinous breast cancer was performed. We evaluated the clinic-pathologic characteristics and survival status. ResultsThe mean age was 59 years. 37 patients underwent modified radical mastectomy; 14 underwent breast-conserving surgery. The 5-years overall survival (OS) and disease free survival (DFS) rates were respectively 75,3% and 74%. According to univariate analysis for OS, age (p = 0,049), menopausal status (p = 0,024), clinical T stage (p = 0,037), N stage (p = 0,002) and pathological T stage (p = 0,033) were statistically significant factors for survival.The DFS was better in postmenopausal women (p = 0,02), histological tumor size smaller than 20 mm (p = 0,024), and negative lymph nodes (p = 0,049). ConclusionPure mucinous breast cancer has a favorable prognosis and is characterized by lower tumor grade, higher hormone receptor expression and lower incidence of nodal involvement. Thanks to its good prognosis, this subtype of cancer should be treated less aggressively than invasive ductal carcinoma.

DIAGNOSTIC ACCURACY OF MAMMOGRAPHY AND MAMMOSCINTIGRAPHY WITH 99M TC-MIBI IN DETECTION OF MINIMAL BREAST CANCER

In 437 primary patients with breast cancer (BC) we compared diagnostic accuracy of mammography (MG) and mammoscintigraphy (MCG) with 99mTc-MIBI. All women, included in the study, had lesions suspicious for BC. In 108 suspicious lesions were less than 10 mm in diameter. On histology 33 (30,5%) patients had invasive BC, 20 (18,5%) - noninvasive BC, 6 (5,6%) - lobular carcinoma, 2 (1,9%) - mucinous BC, 8 (7,4%) - fibroadenoma and in remained 39 cases (36,1%) - localised fibrosis. In the group of women with lesions below 10 mm sensitivity, specificity and accuracy of MG in diagnosis of BC were 72%, 74%, 73%, for MCG - 62%, 51%, 57%. Combination of MG and MCG helped to increase sensitivity to 93,4%. In 53 women with dense breasts sensitivity, specificity and accuracy of MG were 40%, 71,4%, 64%; for mCg two times higher (82%) with specificity of 55% and 60% accuracy. Combination of MG and MCG allowed increasing the sensitivity of diagnosis of minimal BC 2 times more (up to 91%).

Clinical-Pathological Features of an Occult Mixed Mucinous Male Breast Cancer: A Case Report

Mucinous carcinoma of the male breast is an uncommon malignant breast neoplasm and its diagnoses remain difficult. It is probably due to such a low rate of breast cancer cases that men tend to be diagnosed at an older age than women and with a later stage of the disease. We describe a case of a 69-year-old male who displayed a palpable lump in his right axilla several years ago, showing signs of cutaneous adnexal mucinous adenocarcinoma after biopsy. After six years and several clinical examination and systemic investigation without results, the patient underwent to fine needle aspiration cytology and subsequently a biopsy of a mass with irregular margins in the retroareolar region of his right breast. The final diagnosis was of a mixed mucinous breast cancer with neuroendocrine differentiation. The tumor cells phenotype showed Synaptophisin (+), CEA (+/-), CK-20 (-), CK-7 (+), TTF-1 (-), estrogen receptor (-), progesterone (-) and HER 2 (++). These results were unusual for a mucinous male breast carcinoma. In the presence of a lesion in the axillary area with no specific primary origin, breast cancer should never be ruled out, even in the absence of clinical evidence and with an immunohistochemical pattern not indicative of mammary origin.

Clinical Nomogram for Predicting Survival Outcomes in Early Mucinous Breast Cancer.

BackgroundThe features related to the prognosis of patients with mucinous breast cancer (MBC) remain controversial. We aimed to explore the prognostic factors of MBC and develop a nomogram for predicting survival outcomes.MethodsThe Surveillance, Epidemiology, and End Results (SEER) database was searched to identify 139611 women with resectable breast cancer from 1990 to 2007. Survival curves were generated using Kaplan-Meier methods. The 5-year and 10-year cancer-specific survival (CSS) rates were calculated using the Life-Table method. Based on Cox models, a nomogram was constructed to predict the probabilities of CSS for an individual patient. The competing risk regression model was used to analyse the specific survival of patients with MBC.ResultsThere were 136569 (97.82%) infiltrative ductal cancer (IDC) patients and 3042 (2.18%) MBC patients. Patients with MBC had less lymph node involvement, a higher frequency of well-differentiated lesions, and more estrogen receptor (ER)-positive tumors. Patients with MBC had significantly higher 5 and10-year CSS rates (98.23 and 96.03%, respectively) than patients with IDC (91.44 and 85.48%, respectively). Univariate and multivariate analyses showed that MBC was an independent factor for better prognosis. As for patients with MBC, the event of death caused by another disease exceeded the event of death caused by breast cancer. A competing risk regression model further showed that lymph node involvement, poorly differentiated grade and advanced T-classification were independent factors of poor prognosis in patients with MBC. The Nomogram can accurately predict CSS with a high C-index (0.816). Risk scores developed from the nomogram can more accurately predict the prognosis of patients with MBC (C-index = 0.789) than the traditional TNM system (C-index = 0.704, P< 0.001).ConclusionsPatients with MBC have a better prognosis than patients with IDC. Nomograms could help clinicians make more informed decisions in clinical practice. The competing risk regression model, as a more rational model, is recommended for use in the survival analysis of patients with MBC in the future.

Clinicopathological Characteristics of Mucinous Breast Cancer: A Retrospective Analysis of a 10-Year Study.

BackgroundMucinous breast carcinoma (MC) is a special type of breast cancer that presents with a large amount of extracellular mucin. MC comprises approximately 4% of all invasive breast cancers. This type of tumor has a better prognosis and higher incidence in peri- and post-menopausal patients. Pathologically, there are two main subtypes of MC: pure and mixed. In this study, we describe 10 years of experience with MC at the Zhejiang Cancer Hospital in China, specifically, clinical data, histological findings and immunohistochemical features.MethodsWe identified MC patients who were diagnosed as operable and completed clinical treatment from January 2001 to January 2011. The clinicopathological data included the age at diagnosis, tumor size, TNM stage, presence and number of lymph node (LN) metastases, estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER2) status and p53 expression. If the tumor was defined as mixed mucinous carcinoma (MMC), IHC was performed on a non-mucinous part, such as invasive ductal and lobular cancer. We evaluated the clinical characteristics of all MC patients using chi-square, one-way ANOVA and LSD tests. We also studied the correlations between all of the clinical parameters and LN metastasis in a binary logistic regression analysis. We used ten consecutive years of data that were collected at Zhejiang Cancer Hospital.ResultsWe identified 48 cases of pure mucinous carcinoma (PMC) and 77 cases of MMC. The 48 PMC cases consisted of 38 PMC-A and 10 PMC-B subtypes. The MMCs were divided into two groups, those with partial mixed mucinous breast carcinoma (pMMC, 58 cases) and those with main mixed mucinous breast carcinoma (mMMC, 19 cases). pMMC was defined by tumors with less than 50% mucinous components, while mMMC was defined by tumors where the mucinous component accounted for 50% to 90% of the tumor. No significant differences in the clinicopathological characteristics were noted between the patients with PMC-A and those with PMC-B. The tumor size was larger in the mMMC than PMC cases (44.84 mm vs. 30.06 mm, p = 0.021). The number of positive LN metastases was greater in pMMC than PMC patients (p = 0.024). The clinical stages were significantly different among the three groups, with the pMMC group having more stage III-IV patients than the other two groups (p = 0.005). The incidence of LN metastasis was also higher in the pMMC cases (pMMC vs. mMMC and PMC, 50% vs. 31.58% and 18.75%, p = 0.003). The PMC patients had much lower p53 expression than the other two groups (PMC vs. pMMC and mMMC, 27.08% vs. 55.17% and 57.89%, p = 0.007). The tumor size (>30mm), p53 expression and less proportion of the mucinous component are associated with risk of LN metastasis.ConclusionBased on the results of this study, we conclude that the tumor size, status of LN metastasis, clinical stage, and p53 mutation rate may differ between MMC and PMC patients. The tumor size (>30mm), p53 mutation and less proportion of the mucinous component should be considered risk factors of LN metastasis in MC patients.

Clinical characteristics and outcome of mucinous breast cancer: A retrospective analysis of 10-year study.

e13095Background: Mucinous breast carcinoma (MC) is a special type of breast cancer, comprising approximately 4% of all invasive breast cancers. Pathologically, it is divided into two main subtypes, the pure type and the mixed type. In this study, we aimed to report the last 10-year experience of the Zhejiang Cancer Hospital in China regarding MC with its clinical characteristics and outcome. Methods: We used consecutive ten years of data that were collected at Zhejiang Cancer Hospital from January 2001 to January 2011.All patients were divided into three groups: patial mixed mucinous breast carcinoma (pMMC) was defined as less than 50% mucinous component; main mixed mucinous breast carcinoma (mMMC) was defined as mucinous component accounted from 50% to 90%; PMC was defined as mucinouscomponent accounted more than 90%.The clinical pathological characteristics included age at diagnosed, menopausal status, tumor size, clinical stage, lymph node metastasis(LN+), estrogen receptor (ER), prostrogen receptor (...

Prognosis of subtypes of the mucinous breast carcinoma in Chinese women: a population-based study of 32-year experience (1983-2014).

PurposeThe heterogeneous nature of the mucinous breast cancer (MBC), with its pure (PMBC) and mixed subtypes (MMBC), calls for precise prognosis assessment.MethodsWe analyzed 197 consecutive MBC patients, including 117 PMBC and 80 MMBC, who were treated from 1983 to 2014. The clinicopathological features, treatment choice, disease-free survival (DFS) and overall survival (OS) were compared among PMBC, MMBC and MMBC subgroups. Prognostic factors of PMBC and MMBC were identified.ResultsCompared to PMBC, MMBC had more lymph node metastasis (p = 0.043), Her2 positivity (p = 0.036), high Ki-67 index (defined as>20%, p = 0.026) and anti-Her2 targeted therapy (p = 0.016). The 5-year DFS of PMBC and MMBC were 90.4% and 86.2%, whereas the 5-year OS were 99.0% and 98.7%. No significant difference was found in DFS or OS among all MBC subtypes. High Ki-67 (p = 0.020) appeared as DFS factor in PMBC, while anti-Her2 targeted therapy (p = 0.047) as the DFS predictors in MMBC.ConclusionMMBC manifested similar 5-year survival to PMBC in Chinese woman, suggesting that intra-tumoral heterogeneity might not interfere with MBC short-term prognosis.