Pure mucinous carcinomas of the breast: Prognostic study including DNA flow cytometry

Abstract

Background: Prognostic factors for pure mucinous carcinomas of the breast are controversial; data on DNA ploidy and S-phase fraction (SPF) are lacking. We examined the relation of these parameters with histological features and patient survival.Methods: DNA flow cytometry was performed on 69 fresh or frozen pure mucinous carcinomas samples. Results were interpreted according to patient survival.Results: Tumor size exceeded 2 cm in 40.5% of cases. Lymph nodes were involved in 11.5% of cases and never when tumor size was less than 2 cm. Aneuploidy was only observed in one-quarter of the tumors. Very few tumors had a high-SPF or a high histological grade (7.2% of all cases). These two parameters were of prognostic value respectively for disease-free (P = 0.035) and overall survival (0.050). Patients with tumors >2 cm had shorter overall survival than patients with tumors ≤2 cm (P 5 0.028). Disease-free and overall survivals were not influenced by nodal status and hormone receptors (HRs) status. Patients with aneuploid tumors had shorter disease-free survival than patients with diploid tumors (P 5 0.031). The combination of tumor size and DNA ploidy was strongly predictive of survival (P < 10 23 ): six patients with large aneuploid tumors had a poor outcome (1-year overall survival 16.7%).Conclusion: We identified a subset of patients with a poor prognosis, namely those with large aneuploid tumors. This study confirms the good prognosis of pure mucinous carcinomas, particularly when tumor is less than 2 cm (corresponding to cases without lymph nodes involvement), thus challenging the need for axillary nodal examination. q

Pure and Mixed Mucinous Carcinoma of the Breast: A Comparison of Clinical Outcomes and Treatment Results

“…Data from Table , as well as other data from the literature, show that 10‐year DFS is present in 54–90% of patients with PMBC and in 20–66% of patients with MMBC (). There is no doubt that MMBC involves a significantly worse prognosis than PMBC; however, in our patients with pN0, the difference in the 10‐year DFS between PMBC and MMBC was statistically insignificant (92.1% versus 86.7%); in all probability the survival advantage of PMBC was mainly due to a lower incidence of axillary nodal metastases (10.0% versus 25.0%).…”

“…Data from Table and others from the literature show that axillary nodal metastases are present in 0–29% of patients with PMBC and in 17–65% with MMBC ().…”

Carcinoma mucinoso invasor da mama e seus diagnósticos diferenciais em biópsia por agulha grossa: revisão da literatura

“…A incidência desse tipo de carcinoma, também conhecido como coloide, mucoso, mucoide ou gelatinoso, corresponde a cerca de 1% a 2% de todos os carcinomas mamários (7,15,18) . Caracterizado por abundante acúmulo de muco extracelular excretado pelas células tumorais (17) , o carcinoma mucinoso é encontrado geralmente em mulheres na pós-menopausa e é unilateral.…”

“…Histologicamente é caracterizado por aglomerados de células arredondadas, por vezes isoladas, e cercadas por mucina extracelular (Figura) (28) . Ele é dividido em dois subtipos: puro e misto (12,17,18,28) . Para que um carcinoma mucinoso seja diagnosticado puro, é necessário que pelo menos 90% do tumor tenha componente mucinoso (9) .…”

“…Vale destacar que nesses carcinomas existe uma associação entre tamanho do tumor e metástases para linfonodos axilares (2) . Com relação ao prognóstico, o do carcinoma puro é melhor que o do misto (18,22) . A maioria dos carcinomas mucinosos tem grau nuclear 1 e, nesses casos, a sobrevida de 10 anos é superior a 80%; já para grau 2, é de 60% a 80% (22) .…”