[270] 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.

Pure Mucinous Carcinoma (PMC): Morphology and Clinical Features
 PMC without MPF (n=5)PMC with MPF (n=13)PMC pure MP (n=6)All PMC cases (n=24)
Age (median, yrs)33363536
Size (median, cm)1.60.62.41.2
NGlow 1, int 2, high 2int 12, high 1low 1, int 5low 2, int 19, high 3
Mitoses/10hpf4122
Ca2+03 (1P)3P6
LVI1124
TreatmentE1, M4, R1, C3E3, M10, R4, C3E2, M4, R5, C3E6, M18, R10, C9
Patients with LN mets1 of 52 of 101 of 64 of 21
Median FU (m)25376937 (range 8-175)
Local recurrence02 (20m, 52m)3 (39m, 39m, 69m)5
Distant metastases001 (93m, lung; NED 7 yrs after lung surgery)1
Patient status5 NED12 NED, 1 LFU6 NED21 NED
MPF-micropapillary features, MP-micropapillary, NG-nuclear grade, int-intermediate, P-psammomatous, E-excision, M-mastectomy, R-radiotherapy, C-chemotherapy, LFU-lost to follow up


Conclusions: To the best of our knowledge, ours is the largest series of PMC in women ≤40 years. Pure mucinous/micropapillary carcinomas constituted about a fourth of PMCs in this age group and our data suggest they might have a more aggressive course. Nonetheless, our results indicate that the clinical behaviour of PMC in young women is relatively indolent, in keeping with its known biology in other age groups.
Category: Breast

Tuesday, March 20, 2012 1:00 PM

Poster Session IV # 3, Tuesday Afternoon

 

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