Pure Mucinous Carcinoma in Women 40 Years Old or Younger: Clinico-Pathological and Follow-Up Study
Elzbieta A Slodkowska, Adriana D Corben, Jeffrey Catalano, Edi Brogi. Memorial Sloan Kettering Cancer Center, New York, NY
Background: Breast carcinoma in young women is usually aggressive. Pure mucinous carcinoma (PMC) of the breast typically occurs in postmenopausal women and has indolent course. The clinical course of PMC in young women has not been investigated. Our study aims to define the clinico-pathological characteristics and behavior of PMC in women up to 40 years of age (W≤40y).
Design: We searched the 1992-2011 pathology database for carcinomas with associated mucin diagnosed in W≤40 y. Two pathologists reviewed all available slides and identified cases of PMC, defined as having 100% mucinous morphology. Carcinomas with a non-mucinous component or post neoadjuvant treatment were excluded from the study. Morphologic features, including micropapillary morphology, as well as ER and HER2 status of PMCs were recorded. Clinical and follow-up (F/U) information was retrieved from the e-medical records.
Results: We identified 24 PMCs from 21 W≤40y. Nineteen patients (pts) had one PMC, one had 2, one had 3. No pt was pregnant/nursing for at least 22 months (m) prior to diagnosis. Clinical symptoms included a palpable mass (14), nipple discharge (4), mammographic mass (2) or Ca2+ (2). DCIS was present in 19/24 (80%) cases, and was mucin producing in 18/19 (94%). All 21/21 PMCs tested were positive for ER, negative for HER2. Table 1 details morphology and clinical data.
|PMC without MPF (n=5)||PMC with MPF (n=13)||PMC pure MP (n=6)||All PMC cases (n=24)|
|Age (median, yrs)||33||36||35||36|
|Size (median, cm)||1.6||0.6||2.4||1.2|
|NG||low 1, int 2, high 2||int 12, high 1||low 1, int 5||low 2, int 19, high 3|
|Treatment||E1, M4, R1, C3||E3, M10, R4, C3||E2, M4, R5, C3||E6, M18, R10, C9|
|Patients with LN mets||1 of 5||2 of 10||1 of 6||4 of 21|
|Median FU (m)||25||37||69||37 (range 8-175)|
|Local recurrence||0||2 (20m, 52m)||3 (39m, 39m, 69m)||5|
|Distant metastases||0||0||1 (93m, lung; NED 7 yrs after lung surgery)||1|
|Patient status||5 NED||12 NED, 1 LFU||6 NED||21 NED|