不同病理类型乳腺黏液癌超声特征分析

目的：探讨不同病理类型乳腺黏液癌(mucinous breast carcinoma, MBC)的超声声像图特征。方法：回顾性分析38例经手术后病理证实有完整超声检查资料的MBC患者临床资料,分析单纯型乳腺黏液癌(pure mucinous breast carcinoma, PMBC)和混合型乳腺黏液癌(mixed mucinous breast carcinoma, MMBC)超声特征之间的差异。结果：两组患者在肿瘤形态、边界、内部回声、后方回声、血流信号Adler分级、弹性评分、肿瘤良恶性诊断方面存在差异(均P<0.05)。而在肿瘤部位、边缘、瘤内钙化及腋窝淋巴结转移、瘤内峰值血流速度(PSV)和阻力指数(RI)之间差异均无统计学意义(均P>0.05)。结论：PMBC和MMBC超声特征和肿瘤良恶性诊断方面存在差异,PMBC易误诊为良性病变,因此,高龄女性乳腺内发现中等回声、后方回声增强、突向脂肪层膨胀性生长且弹性评分较低、RI较高的肿块时,超声医师应考虑到黏液癌的可能。     

化生性乳腺癌的临床病理特点及诊疗现状

化生性乳腺癌(metaplastic carcinoma of the breast,MBC)是一种罕见的、异质的、具有侵袭性的乳腺癌,被世界卫生组织认定为一种特殊病理类型的乳腺癌。与乳腺浸润性导管癌（invasive ductal carcinoma,IDC）相比,MBC可能表现出部分倾向于良性肿瘤的特征,相对较少的腋窝淋巴结转移等。与纯粹的IDC相比,化生性乳腺癌有其独特的病理特性。由于肿瘤的罕见性,对MBC的治疗相对不为人知,但研究表明肿瘤切除和辅助放射治疗有最大的益处。     

乳腺原发性鳞状细胞癌一例

乳腺原发性鳞状细胞癌（primary squamous cell carcinoma of the breast,SCC）是乳腺癌中一种少见的类型,为乳腺化生性癌的一种,所占比例不到乳腺癌的1％。在组织学上,乳腺鳞状细胞癌与其他部位的鳞状细胞癌并无区别,以癌珠及细胞问桥形成为特点。本文报道本院收治的1例乳腺原发性鳞状细胞癌病例。     

乳腺巨大富脂质性癌一例

乳腺富脂质性癌(lipid-rich carcinoma of breast,LRCB),又称乳腺分泌脂质性癌(1ipid-secreting carcinoma),是一种罕见的特殊类型乳腺癌。国外报道其约占乳腺癌的1%~2%[1],国内报道占0.77%[2]。由于该病发病例数少,文献报道也较少,对该病的临床治疗和预后总结不多,易误诊误治,造成患者病情延误。笔者于2013年8月收治了1例乳腺巨大富脂质性癌,现报道如下。     

男性乳腺黏液癌一例临床病理分析

正男性乳腺癌很少见,占全部乳腺癌的0.6%,男性恶性肿瘤的1%以下,最常见的男性乳腺癌是非特殊类型的浸润性导管癌,占90%~([1])。近年来,男性乳腺癌的发病率和病死率均有增长的趋势~([2])。乳腺黏液癌(mucinous carcinoma)又称胶样癌,约占女性乳腺癌的2%~([1]),但发生在男性的乳腺黏液癌极其罕见,至今国内外仅见数例报道~([3-4])。笔者报道1例男性乳腺黏液癌,结合相关文献,对其临床病理特征、免疫     

乳腺分泌性癌的研究进展

乳腺分泌性癌（ secretory carcinoma of the breast ）是一种发生于成人和儿童的罕见肿瘤。1966年, McDivitt和Stewart ［1］报道了一组患有该肿瘤的年轻病例,并称之为幼年型癌。然而,文献报道大多数患者并非年幼患者,而是成年患者,因此“乳腺幼年型癌”被重新命名为分泌性癌［2］。相对于其他类型的乳腺癌而言,分泌性癌有其特殊的流行病学、大体形态、组织学形态、免疫表型和遗传学特点,因此被认为是一种独立的组织学类型。2003年和2012年乳腺肿瘤病理学及遗传学分类（世界卫生组织肿瘤分类及诊断标准系列）将乳腺分泌性癌列为独立的类型,归入特殊类型的乳腺癌［3-4］。但是,有关该类型癌的组织起源仍存在争议,临床病理诊断易与其他乳腺肿瘤相混淆,年轻人与老年人预后也有所不同。本文就乳腺分泌性癌诊断与治疗的研究进展作一综述。     

乳腺粘渡性腺癌5例

乳腺粘渡性腺癌５例山东省单县中心医院武培敬，石晓燕乳腺粘液性腺癌亦称胶样癌或改性癌，是一种少见的特殊类型乳腺癌，国内文献报道发生率占所有乳腺癌的２～３％，１９７０～１９９０年内在我院乳腺癌标本内见粘液性腺癌５例，报告如下；临床资料：均为女性。就诊时年...     

乳腺黏液癌的X线表现及临床病理特征

目的:探讨分析乳腺黏液癌(breast mucinous carcinoma,MBC)的X线影像学特征及临床病理特征.方法:收集2010年1月至2016年12月间临床资料完整的乳腺黏液癌患者75例,其中单纯性乳腺黏液癌(pure MBC)患者54例,混合型乳腺黏液癌(mixed MBC)患者21例.分析比较两组患者的X线影像学表现和临床病理特征.结果:在两组乳腺癌患者中,单纯型乳腺黏液癌与混合型乳腺黏液癌比较,混合型乳腺黏液癌更多表现为淋巴结转移阳性(P=0.002);在年龄、月经状况、家族史、ER、PR、HER2水平方面差异无统计学意义(P>0.05);在钼靶x线检查,肿块平均大小及肿块边缘差异具有统计学意义(P=0.000),而患者年龄、肿块形态及微钙化特征组间比较不具有统计学意义(P>0.05).结论:了解乳腺黏液癌的X线影像学及临床病理特征,可帮助临床医师预测乳腺黏液癌及其亚型和患者的预后,有利于制定最优的治疗方案.     

乳腺黏液癌的MRI表现及与临床病理特征相关性分析

目的:探讨分析乳腺黏液癌（mucinous breast carcinoma,MBC）的MRI影像学特征及临床病理特征。方法:收集2010年1月至2016年12月间临床资料完整的乳腺黏液癌患者75例,其中单纯型乳腺黏液癌（Pure MBC）患者54例,混合型乳腺黏液癌（Mixed MBC）患者21例。分析比较两组患者的MRI影像学表现和临床病理特征。结果:在两组乳腺癌患者中,单纯型乳腺黏液癌与混合型乳腺黏液癌比较,混合型乳腺黏液癌更多表现为淋巴结阳性(P=0.002);在年龄、月经状况、家族史、雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体2（HER2）水平方面差异无统计学意义（P<0.05）;在MRI检查方面,肿块平均大小及肿块边缘、形态、强化方式、强化程度及表观弥散系数(ADC)差异具有统计学意义(P<0.001)。结论:了解乳腺黏液癌的MRI影像学及临床病理特征,可帮助临床医师预测乳腺黏液癌及其亚型和患者的预后,有利于制定最优的治疗方案。     

乳腺黏液癌7例临床病理分析

目的：探讨乳腺黏液癌的临床及病理特征,对其诊断、病理分型和鉴别诊断进行讨论。方法：对7例乳腺黏液癌患者进行回顾性分析,同时复习相关文献。结果：本组黏液腺癌占同期乳腺癌的4.73%,中位年龄42岁,绝经前患者占71.43%,病灶大小1.0-6.5cm。单纯型黏液癌均无腋窝淋巴结转移,混合型转移率为33.33%。结论：国内30-50岁女性,临床诊断为良性纤维瘤的乳房肿块,需警惕为乳腺黏液癌。乳腺黏液癌生长缓慢,预后较好。     

Mucin expression in mucinous carcinoma and other invasive carcinomas of the breast.

To investigate mucin expression in breast cancer, immunohistochemical staining was performed on 30 mucinous carcinomas and 95 non-mucinous invasive carcinomas. MUC2 expression was detected in all mucinous carcinomas, but only in 11.1% of invasive ductal carcinomas, and in none of the invasive lobular carcinomas and medullary carcinomas. MUC1 is often expressed in invasive breast carcinoma, but not in medullary carcinoma. Strong cytoplasmic staining was seen in invasive ductal carcinoma, in contrast to surface membrane staining in mucinous carcinoma and intracytoplasmic vacuole staining in invasive lobular carcinoma. CA19-9 and CA50 expression in more than 25% of tumor cells was seen in 17.2 and 16.0% of invasive ductal carcinomas, respectively, but not in mucinous carcinomas. CA125 and human gastric mucin were rarely expressed in breast cancer, irrespective of histologic type.     

Mucinous cancers have fewer genomic alterations than more common classes of breast cancer

Mucinous cancers of the breast are distinguished histologically by their abundant pools of mucin and low degree of nuclear pleomorphism. Relative to the more common breast cancers of no distinctive type (ductal carcinoma), mucinous cancers have a relatively favorable prognosis. In a study of chromosomal changes in mucinous cancers, we evaluated the extent of loss of heterozygosity (LOH) at chromosomal regions commonly deleted in usual infiltrating ductal carcinoma, including markers on chromosomal arms 1p, 1q, 3p, 6q, 8p, 9p, 11p, 11q, 13q, 16q, 17p, and 17q. Remarkably, we found an average frequency of LOH of only 1.9 of these 12 chromosomal arms in 18 cases of mucinous carcinoma, compared to an average frequency of LOH of 6.4 of these same chromosomal arms in cases of infiltrating ductal cancer. In three of the 18 cases of mucinous carcinoma studied, including one case with regional lymph node metastases, no LOH was seen at any of the 12 chromosomal regions studied. We considered the possibility of other chromosomal loci being more commonly affected in mucinous cancers and conducted comparative genomic hybridization on six of the cases. These studies demonstrated a low overall frequency of genomic copy number changes (mean of 3.1 changes per case) and failed to reveal any other chromosomal locus with frequent losses that had not been evaluated by microsatellite analysis. Together, these data indicate that mucinous cancers of the breast do not have the extensive genomic alterations that are typically found in more common variants of breast cancer. Thus, mucinous cancers most likely have less genetic instability than most other forms of breast cancer and the molecular pathogenesis of this form of breast cancer is likely to be substantially different than that of usual ductal breast cancer.     

A case of mucinous carcinoma of the male breast with unusual ultrasonographic findings mimicking phyllodes tumor

Mucinous carcinoma of the male breast is a rare histological type of cancer. We describe a 35-year old male with mucinous carcinoma of the right breast. His breast mass enlarged subacutely, and became painful over a period of 2 months. Ultrasonography demonstrated echoes of a large multilocular cystic lesion with partially heterogenic internal echoes suggesting a phyllodes tumor. A modified radica mastectomy was performed, and histopathologic examination revealed mucin-producing solid or cribriform atypical cells with fibrous granulation tissue and hemosiderin deposition. The patient recovered uneventfully, and is still free of recurrence 30 months after his operation. The prognosis for male breast cancer can be improved by early diagnosis and appropriate multidisciplinary therapy.     

Isoechoic axillary lymph node metastases of mucinous carcinoma of the Breast: A case report

We report a case of isoechoic axillary lymph node metastasis of mucinous carcinoma (so-called pure mucinous carcinoma) of the breast. A 47-year-old premenopausal woman was referred to our hospital with a 2 years history of mass and distortion of her left breast and with recent worsening of her symptoms. Ultrasonography demonstrated a well-circumscribed mass, about 5 cm in diameter, which was isoechoic compared to the surrounding fat tissue. Distal enhancement was also recognized. A left axillary ultrasonographic scan demonstrated four nodules, which were indistinct because of their isoechogenicity compared to the surrounding tissue. Based on a preoperative diagnosis of mucinous carcinoma of the left breast with left axillary lymph nodes metastases, left mastectomy and left axillary nodal dissection were performed. Mucinous carcinoma with axillary lymph node metastases was diagnosed histologically. The lymph node metastases showed histological findings identical to those of the primary tumor, which was considered to be the reason for their isoechogenicity. Although lymph node metastasis of mucinous carcinoma of the breast is rare, ultrasonographers should perform careful scanning when the primary breast mass is suspicious for mucinous carcinoma, because lymph node metastases of mucinous carcinoma can be more indistinct and difficult to detect than those of other types of breast cancer.     

Massive mucinous carcinoma of the breast untreated for 6 years

 We report a patient with a massive mucinous carcinoma of the breast that had been untreated for 6 years. A 47-year-old premenopausal woman presented with a large right-breast mass. Although she had noticed a lump in the right breast 6 years previously, she had not sought treatment. The tumor had enlarged gradually and become ulcerated. With a diagnosis of advanced breast cancer with skin invasion, she underwent right mastectomy with a free skin graft. No lymph node metastases or distant metastases were detected. The histologic diagnosis of the tumor was pure mucinous carcinoma of the breast with no component of ordinary invasive ductal cancer. She has been well without evidence of tumor recurrence for 7 years after the surgery. The prognosis for mucinous carcinoma of the breast has been recognized as relatively good. The results in our patient are consistent with the biological behavior of this carcinoma. Received: August 29, 2002 / Accepted: December 12, 2002 Correspondence to:F. Yoneyama     

乳腺印戒细胞癌和粘液腺癌的临床病理分析

目的 :比较研究乳腺印戒细胞癌和粘液腺癌的临床及病理学特点的差异。方法 :对 11例乳腺印戒细胞癌和 58例乳腺粘液腺癌的临床和病理特征进行对比分析。结果 :乳腺印戒细胞癌 3年生存率 63.63% ,5年生存率 9.0 9% ,粘液腺癌 3年生存率 94 .83% ,5年生存率 81.0 3%。显微镜下二者粘液分布不同 ,肉眼所见大体标本相差甚远。结论 :乳腺印戒细胞癌较粘液腺癌恶性程度高、预后差 ,在临床上有必要从粘液腺癌中独立出来。     

Glucocorticoid receptors and the histological structure of breast cancer

Glucocorticoid receptors (GR) were studied in tumor cytosols from 140 breast cancer patients. The level of GR depended upon tumor histology. The highest GR level was found in medullary cancer, while the lowest--in a mucinous one. The GR level in ductal-invasive cancer was significantly higher than in the lobular infiltrative type. The frequency of GR in tumors of the 1st grade of malignancy was significantly lower than in those of the 2nd and 3rd grade of malignancy. The 1st grade of malignancy tumors which contained GR had estrogen and progesterone receptors, too. The increasing malignancy was matched by the rising percentage of such tumors which was as high as 47% among 3rd grade of malignancy tumors.     

Mammographic and clinicopathological features of mucinous carcinoma of the breast

BACKGROUND: We attempted to improve the effectiveness of diagnostic techniques in mammographic imaging of mucinous carcinoma of the breast by defining the characteristics of mammographic images and investigating correlations between these images and various clinicopathological findings. METHODS: Clinicopathological investigations of 92 lesions in 90 cases of mucinous carcinoma of the breast were made. Mammography demonstrated 80 lesions with identical tumor shadow characteristics and these were divided into three patterns, circumscribed, indistinct and blended. Correlations between clinicopathological findings and mammographic images were investigated. RESULTS: Patients with mucinous carcinoma of the breast usually present with a palpable mass. The lymph node metastasis rate in this study was low and prognosis in the early postoperative period was satisfactory. On mammograms, the circumscribed pattern was the most frequent. The investigation of the correlation between histological sub-type and mammographic pattern showed a high percentage of pure type lesions exhibited in the circumscribed pattern while those of mixed histologic type often showed the indistinct pattern. Calcification frequency demonstrated on mammography was 75% for the indistinct and mixed patterns, and approximately 50% for the circumscribed pattern. A high rate of calcification seen outside the tumor shadow suggested a high frequency of invasion and the spread of cancer to neighboring tissues. The circumscribed pattern was least frequently associated with lymph node metastasis, followed by the indistinct and blended patterns in that order. CONCLUSION: Investigation of clinicopathological factors and mammographic findings in mucinous carcinoma of the breast suggests that mammography provides clinically valuable information for the treatment of this disease. These findings indicate the importance of careful mammographic observation at the time of diagnosis.