Mucinous breast carcinoma showing as a cluster of suspicious microcalcifications on mammography

Abstract

We report a case of mucinous breast carcinoma whose mammographic features consisted of a suspicious cluster of microcalcifications as the unique sign of malignancy. The lesion was non-palpable and measured approximately 2 cm at the greatest diameter. The microcalcifications showed several morphologies: round, pleomorphic, and fine shapes were identified. The total number of microcalcifications was > 30 and the number per square centimeter varied from 10 to 20. The histological calcifications showed good correlation with the mammographic ones and were localized predominantly at the periphery of the tumor inside ducts with ductal carcinoma in situ or in the acellular mucin. Two types were observed: psammomatous and gross-irregular calcifications. To our knowledge, only one case with similar findings has been reported previously.

Pure mucinous carcinoma of the breast with extensive psammomatous calcification

“…Of invasive carcinomas of the breast, non‐psammomatous calcifications are much more frequently observed, and can be abundant, in some special types of tumour such as tubular carcinoma and solid invasive papillary carcinoma 7 . Amongst mucinous carcinomas of breast, calcifications are found most often in those tumours with papillary or comedo epithelial growth patterns, 7,8 but ‘irregular’ calcifications have been reported to be more frequent than psammomatous microcalculi 9 . To the best of our knowledge, only four cases of pure mucinous carcinoma with psammomatous calcifications have been reported so far, 5,8–10 and none has described psammoma bodies in such abundance as in our case.…”

“…Amongst mucinous carcinomas of breast, calcifications are found most often in those tumours with papillary or comedo epithelial growth patterns, 7,8 but ‘irregular’ calcifications have been reported to be more frequent than psammomatous microcalculi 9 . To the best of our knowledge, only four cases of pure mucinous carcinoma with psammomatous calcifications have been reported so far, 5,8–10 and none has described psammoma bodies in such abundance as in our case. In addition to the rare occurrence of psammoma bodies in pure mucinous carcinoma, these calcifications have also been reported in other lesions of breast such as invasive apocrine carcinoma (in a male breast) 11 and apocrine papilloma 12 …”

Diagnostic Features of Mammographic and Ultrasound Mucinous Carcinoma of the Breast

“…Признаки фокальной атипии, фигуры митоза и микрокальцинаты не характер-ны, но иногда выявляются. Внутриклеточные скопления слизи встречаются редко [2,21,29]. Для «чистой» формы слизистого РМЖ характерны эстро-ген-и прогестрон-позитивность, отсутствие экспрессии HER-2, а также низкий уровень пролиферативной актив-ности Ki-67 [8,10,14].…”

“…Особенные сложности возникают при развитии дисгормональных дисплазий молочной железы, при которых дифференциация контуров затруднена даже при использовании специальных методик при маммогра-фии. Крайне редко в образовании определяются микро-кальцинаты [21,25]. Ультразвуковая семиотика слизистого рака неспецифич-на.…”

Mucinous Breast Carcinoma Presenting as a Coarse and Densely Calcified Mass on Mammography: A Case Report

“…Mucinous breast carcinoma is a rare histological subtype of invasive ductal carcinoma (IDC), accounting for 1-7% of all breast carcinomas (1), and it is also known as mucoid, colloid, mucous, or gelatinous tumor carcinoma (2). Mucinous carcinoma is characterized by the presence of extracellular epithelial mucin that surrounds neoplastic Dense Calcified Mucinous Breast Cancer cells (3). Mucinous breast carcinoma has a favorable prognosis and an excellent long-term survival rate (4).…”