Mucocele-like lesions of the breast: a long-term follow-up study

Abstract

BackgroundMucocele-like lesions (MLL) of the breast were originally described as benign lesions composed of multiple cysts lined by uniform flat to cuboidal epithelium with extravasated mucin, but subsequent reports described the coexistence of columnar cell lesions (CCL), atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS). Several reports have investigated whether core biopsy can diagnose MLL reliably; however, there is only one report with a long-term follow-up after excision of MLL. We report here 15 surgically excised MLL with a long-term follow-up.FindingsFifteen lesions diagnosed as MLL from 13 patients who had undergone excisional biopsy between January 2001 and December 2006 were retrieved and followed-up for 24-99 months (median 63.8). Two lesions were accompanied with CCL, 5 with ADH and 3 with low grade DCIS. Four lesions (2 ADH, 2 DCIS) were additionally resected and their histology revealed 2 ADH, one DCIS and one MLL with CCL. Of 4 lesions (3 ADH, one DCIS) without additional resection, one lesion (ADH) relapsed accompanied with DCIS at 37 months after excision.ConclusionsMLL were frequently accompanied with CCL, ADH or low grade DCIS. Complete resection may be recommended in case of MLL with ADH or DCIS because of intralesional heterogeneity and the probabilities of relapse.

Which patients require or can skip biopsy for breast clustered microcysts? Predictive findings of breast cancer and mucocele-like tumor

“…Although Rosen called these lesions a ''mucocele-like tumor'' [9], many reports have used the term ''mucocelelike lesion'' as mentioned above [12][13][14][15][16]. Weaver et al [18] suggested the presence of a spectrum of mucinous lesions of the breast which represents a pathological continuum.…”

“…In later years, several other studies reported that ADH, DCIS, and IC are observed with MLTs [10][11][12]. It has been reported that 13-23.1 % of mucocele-like lesions (MLLs) that were diagnosed by needle biopsy were finally diagnosed as malignant (DCIS or invasive ductal carcinoma) by excision biopsy [13][14][15][16]. Sutton et al performed excisional biopsy in 38 out of 50 patients with MLL and diagnosed 5 patients with DCIS, 4 patients with ADH, and 29 patients with benign lesions [15].…”

Outcome of pure mucocele‐like lesions diagnosed on breast core biopsy

“…All patients in the initial report were benign, except one who had a separate unrelated non‐mucinous intraductal carcinoma (DCIS), and they remained well after a follow‐up of 6–88 months. Subsequent studies showed that MLL could be associated with atypical ductal hyperplasia (ADH), DCIS or mucinous carcinoma . The frequency of malignancy after a diagnosis of MLL without atypia on core biopsy reported in the literature shows a wide range, due mainly to the small number of patients, with only one series having more than 10 patients …”

“…[2][3][4][5][6][7][8][9][10][11] The frequency of malignancy after a diagnosis of MLL without atypia on core biopsy reported in the literature shows a wide range, due mainly to the small number of patients, with only one series having more than 10 patients. [9][10][11][12][13][14][15][16][17] Although the UK national guidelines recommend categorizing MLL diagnosed on core biopsy of the breast as lesions of uncertain malignant potential (B3), 18,19 the outcome of pure MLL and its positive predictive value for malignancy remains uncertain. In the current study, we aimed to assess the outcome of a large series of pure MLL diagnosed on core biopsy and to review the literature, to provide evidence that can guide further management.…”

Self-assessment: breast pathology

“…15,16 In the majority of cases, lesser disease ranging from columnar cell change up to DCIS is found. 17 In the case illustrated here, a diagnostic excision was performed which showed mostly further mucocele-like lesion. In one field a single portion of epithelium was seen free within the mucin pool, but the overall configuration suggested displacement rather than a mucinous carcinoma ( Figure 9).…”