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Mucinous Carcinoma of the breast

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  • Stena3912
    Stena3912 Member Posts: 18
    edited April 2012

    Yeh, Virginie!!!! Such wonderful news!

    I admit, it was amazing how little pain was involved (even though I still filled the vicodin rx - LoL)!  What hurt the most was that silly yet much needed IV.  When I took off the pressure bandage, there was a divet but I was amazed that within 2 days time, it had filled in and all that was left was the scar.  I have several other scars from surgeries (appendectomy/c-section/thyroidectomy) that for me, it's just one more for the collection.  I'm actually proud of my scar, it will serve as a constant reminder for so many things: blessed, strength, courage and perserverance.

    Peace to us all!

  • Golden01
    Golden01 Member Posts: 527
    edited April 2012

    Virginie - Good wishes coming your way and congratulations on the good news! I'm impressed you are up and typing well so quickly!

  • tricianneAust
    tricianneAust Member Posts: 153
    edited April 2012

    Hi Girls, I only had 4 days not logging in and look at all the activity on here. I feel a bit like RipVanWinkle waking up after a deep sleep. I have only been using my handwritten prayer list to keep my prayers current for you as I had interstate visitors (still have until the weekend but they have gone to bed early) so didn't get to log in. So I am blown away by all the activity on this link. God bless you VoraciousReader for keeping so logged in and on top of all the new requests for support and information. I am so glad you had failth VR that I would turn up again. Its good to hear from Golden01 and katiekaboom

    So welcome to our newcomers, DTBrooks52, Stena, Janet and Virginie you have made it to a faithful prayer list down under in Australia, so I will keep you covered with regular prayer, that's the bit I can do for you all. Its sad that you had to join us but the journey while it has its ups & downs is far easier that I ever anticipated once the initial fears are sorted out and treatment is underway. I turned 70 just last week so some of you are a lot younger and I have managed very well. While I am normally very strong emotionally & spiritually it is good to let down all the emotions & tears and fall apart for a while. It is a scary business until it all settles down. I do continue to think of Peggym but I suspect that she would be likely to log back in if she wanted support as this link is so helpful. I don't access any other links now including the Australian Breast Cancer link I just try to keep logged into this one at least twice a week as I feel I have so much in common with you all and can give emotional & spiritual support and in some way repay the enormous help this link and Voraciousreader have been to me at such a stressful time of my life. Like VR I feel drawn back here constantly but as far as the breast cancer is concerned mine feels like a past episode of my 60's life. I would normally have faded out as I am truly back to the new normal. If I fade out of this link which when life gets super busy is always possible,I am quite happy if any of you email me in Australia at pahunt@adam.com.au

    No I have not had any mucus issues like bronchitis, asthma etc. 11yrs ago I had a type of mucinous bowel cancer, from which I am totally recovered according to my now 3yrly colonscopies and forget about that most of the time but for a colostomy which causes me very little problem. So God Bless to you all and remember the new normal is ahead of you quicker that you can possibly imagine.

  • voraciousreader
    voraciousreader Member Posts: 3,696
    edited April 2012

    Risk factors for uncommon histologic subtypes of breast cancer using centralized pathology review in the Breast Cancer Family Registry.

    Work ME, Andrulis IL, John EM, Hopper JL, Liao Y, Zhang FF, Knight JA, West DW, Milne RL, Giles GG, Longacre TA, O'Malley F, Mulligan AM, Southey MC, Hibshoosh H, Terry MB.

    Source

    Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St., 7th Floor, New York, NY, 10032, USA.

    Abstract

    Epidemiologic studies of histologic types of breast cancer including mucinous, medullary, and tubular carcinomas have primarily relied on International Classification of Diseases-Oncology (ICD-O) codes assigned by local pathologists to define histology. Using data from the Breast Cancer Family Registry (BCFR), we compared histologic agreement between centralized BCFR pathology review and ICD-O codes available from local tumor registries among 3,260 breast cancer cases. Agreement was low to moderate for less common histologies; for example, only 55 and 26 % of cases classified as mucinous and medullary, respectively, by centralized review were similarly classified using ICD-O coding. We then evaluated risk factors for each histologic subtype by comparing each histologic case group defined by centralized review with a common set of 2,997 population-based controls using polytomous logistic regression. Parity [odds ratio (OR) = 0.4, 95 % confidence interval (95 % CI): 0.2-0.9, for parous vs. nulliparous], age at menarche (OR = 0.5, 95 % CI: 0.3-0.9, for age ≥13 vs. ≤11), and use of oral contraceptives (OCs) (OR = 0.5, 95 % CI: 0.2-0.8, OC use >5 years vs. never) were associated with mucinous carcinoma (N = 92 cases). Body mass index (BMI) (OR = 1.05, 95 % CI: 1.0-1.1, per unit of BMI) and high parity (OR = 2.6, 95 % CI: 1.1-6.0 for ≥3 live births vs. nulliparous) were associated with medullary carcinoma (N = 90 cases). We did not find any associations between breast cancer risk factors and tubular carcinoma (N = 86 cases). Relative risk estimates from analyses using ICD-O classifications of histology, rather than centralized review, resulted in attenuated, and/or more imprecise, associations. These findings suggest risk factor heterogeneity across breast cancer tumor histologies, and demonstrate the value of centralized pathology review for classifying rarer tumor types.

  • FeelingtheMagic
    FeelingtheMagic Member Posts: 103
    edited April 2012

    Yay, Virginie! So happy to hear you are doing well. Sending you speedy healing and joyfilled wishes.

     My surgery is next Wednesday. Tomorrow my artist friends are coming to paint, and then photograph, my breasts. Then we are also making plaster casts. Lord knows what for, but I am a potter.. so perhaps they'll be a form for teacups. ha!.  Feels like a joyful, playful, celebration that feeds my soul pre surgery.  Oh, and I'll post pictures. I suspect this group will appreciate the concept.  My doctor called this event "titillating art" so I do believe we have a very good name for the project.

    Thank goodness for people finding nice things for me to do this week in amongst the learning, appts, and craziness.  Despite the recent lumpectomy, I am going paddleboarding. What the heck.. they're removing my poor breast anyway,  Connecting to the things I love pre surgery is helping.    

    Again, so appreciative of all that is posted here, and all of you. 

  • Virginie
    Virginie Member Posts: 8
    edited April 2012

    Hi Janet,

    Fantastic you are being so positive. Great idea to have a painting and cast. I made some photographs myself.

    Before leaving the hospital I got some bad and some good news. The good news is that the lymph nodes are clean. The bad news is that the margins aren't.

    One BS suggests another excision next week. The other BS suggests to have a mastectomy. They were even willing to operate on me today! Feeling a bit overwhelmed I said I wanted to think it over.

    Meanwhile I spoke to quite a few people. All the doctors advise MX.

    A good friend arranged for an appointment with one of the best reconstructive surgeons on Wednesday. I think it's a good idea if I see him before surgery.

    Any advise? I also read/hear some controversial advise of doing reconstructive surgery immediately after MX? Any experience there.

    Pffff, I really feel like being on a rollercoaster! My 23 year old daughter has a hard time too. With her exams coming up, I'm worried she will not concentrate enough. My husband and son are holding strong.

    Thanks for all your support!

  • Stena3912
    Stena3912 Member Posts: 18
    edited April 2012

    Virginie:  I completely and utterly feel for you.  My nodes were negative yet my margins were positive.  So very, very frustrating!! I opted for a re-excision which was what my surgeon suggested.  Second time, clear margins with a good margin!  What was very amazing was that I did not hurt at all from the re-excision.  Didn't even need motrin. I say I wouldn't rush into anything yet I couldn't wait to get it out and over with!! It was difficult to be rationale so hopefully, you have someone to support you (and your daughter) think through this chapter.

    Yes, rollercoaster is right!  At least you're not on the ride alone!  I had my appt yesterday with my Rad Onc.  Even though my rollercoaster had slowed down, it gained speed again but nothing compared to the initial slew of bx's & surgeries. 

     Janet: I can't wait to see the pictures!! :-)

     Peace & wellness to us all!

  • Virginie
    Virginie Member Posts: 8
    edited April 2012

    Stena, thank you for your kind message. Amazing how many people are willing to help me with advice, friendship, callls, emails, flowers etc. Can't wait to see my oncologist to see what she has to say. Tonight at a dinner party I'm seeing another oncologist who works in the same breast center as mine. I will definitely pick her brain too!

    All the best to all of you and enjoy your Sunday!

  • Stena3912
    Stena3912 Member Posts: 18
    edited May 2012

    Just thought I would throw something out here since activity has been slow (thank goodness!). Saw my first Med Onc (one outside of my facility).  Left dissappointed only because I learned nothing new which I guess I should be thankful for.  So, I decided to make an appt with another Med Onc in the same town.  Oh, just 5 short years of Tamoxifen.  Why is it that I'm dreading this so much?!  Perhaps because I do not like taking any medication (I can barely remember my daily vitamin) and there's the unknown side effects or how it will affect me.  Then had my consult with our Rad Onc, he's a hoot!  Had my CT yesterday plus 4 free tatoos.  :-)  Not exactly what I had in mind but sometimes life's like that.  I start radiation this Thursday - memories in the making! 

    Thanks for listening!  :-)  Peace to us all!! 

  • voraciousreader
    voraciousreader Member Posts: 3,696
    edited May 2012

    Stena...I wish you well with the rest of your active treatment....Thanks for keeping us posted!!!!!!

  • tricianneAust
    tricianneAust Member Posts: 153
    edited May 2012

    Hi Stena, Thinking of you and praying for you with Radiation starting Thursday, its already Thursday in Australia. Radiation was much easier that I anticipated according to all I had heard. I attribute this to the advice I was given.My radiation oncologist does firmly believe that if you walk for at least 30 mins after your treatment it gives the body a chance to re balance itself after the radiation "onslaught" as he calls it. Drinking plenty of water does a good job of rehydrating you and using heaps of cream protects the skin. My friend who had 6 1/2 wks of radiation treatment just 2 months prior to me gave me heaps of good advice and she breezed through it too. I certainly would't be fearful if ever it was essential for me to need radiotherapy in the future. I also scheduled the daily treatment into my life as an essential (on my friend's advice) so that I didn't resent the daily trips to the hospital but appreciated the medical facilities that were so available to me.What a blessing to have such treatment and support available. As well I planned special treats each day, like meet a special friend afterwards or go to a coffee shop for a recharge. Another friend's husband bought her scratchie tickets one for each treatment day and she won $100 towards the end! I have another friend who was too tired to do the walking, hates drinking water and didn't use much of the cream especially straight after the radiation, she did not fare so well.

    As for Tamoxifen I too was not keen to take it as I got vertigo when taken HRT however while the first 3 months was a little difficult,it soon improved, it is said that that is the usual time it takes to sttle down.  I had a few "panic attacks" ( I had experienced these 30 yrs earlier after excessively high temps during malarial episodes) I had no depression, no vertigo, I was a little tired and had vaginal discharge. After that it all settled down and from then I  don't even feel that I am on Tamoxifen via the Side Effects. So hope that helps you. My prayer is you will cope easily with it all. Now I look back if ever I have to do it again, which I hope I will not, I will happily do it all over.

  • voraciousreader
    voraciousreader Member Posts: 3,696
    edited May 2012

    Came across this magnificent book, The Art of Medicine:

    http://www.amazon.com/The-Art-Medicine-Images-Imagination/dp/0226749363

    Thumbing through the pages, I came across 18th Century women's novelist, Frances "Fanny" Burney.  While most people might be familiar with her most famous book, Evelina, I learned in the book that she wrote, in vivid detail, about the mastectomy that she had in 1811.  She passed in 1840...well into her 80's.

    Talk about survivors....Fanny should be our poster woman!  Kiss  Imagine...back in the 1800's to be able to WRITE about breast cancer...and continue to have a successful career and very long life following a mastectomy.....Amazing!  Wondering if she had mucinous breast cancer when she was diagnosed??? Anyway....I am posting this hoping to cheer everyone up.  When you're thinking of going to a dark place.....think of Fanny instead!

  • Stena3912
    Stena3912 Member Posts: 18
    edited May 2012

    Thanks, voraciousreader!  Cheering up is always welcome!

    While I realize that this group isn't to give medical advise but I would greatly appreciate a couple of opinions.  Again, I started radiation this past Thursday.  I had an appt today with a second Medical Oncologist (which was a refreshing and pleasant experience).  My question is:  Am I nuts for thinking about not taking Tamoxifen?  Stg 1, mucinous - good histology.  NCCN guidelines say to consider hormonal therapy. He wasn't pushing either direction, just providing his medical advice.  I am going to speak further with my Rad Onc and Surgeon for additional opinions too.  I would love to hear from ladies that have been there, done that.  Either way, there's always going to be the 'what it' or 'should of, could of, would of' thoughts. 

  • Golden01
    Golden01 Member Posts: 527
    edited May 2012

    You are not nuts. I think you are paying good attention to all the questions you need to ask. The one suggestion that I might offer is to be sure a second pathologist evaluates your slides and that you know for sure if you have a "pure" or "mixed" form of mucinous carcinoma. Look for the info on this thread posted by Red Sunshine. Her words of wisdom were so helpful for me but came after I'd made the decisions about chemotherapy. Turned out that I have the "mixed" kind or in the words of the second pathologist "mucinous carcinoma hypercellular variant".

  • voraciousreader
    voraciousreader Member Posts: 3,696
    edited May 2012

    Stena.... You read the latest NCCN guidelines correctly that said to CONSIDER hormonal therapy. When I was diagnosed in 2010, it was RECOMMENDED. Since being diagnosed it seems that the NCCN guidelines have become more relaxed with recommending treatment for our type of breast cancer.





    Now if you are asking what I would do, it's simple. I would recommend trying it and see if you can tolerate it and it doesn't affect your quality of life. Every few months, under doctor's supervision, I would re-evaluate taking the med depending upon whether or not I would get side effects. No decision is written in stone. You can decide not to take it and you may also change your mind in a few months and choose to try it.



    My MO kind of convinced me to try it, mind you my Oncotype DX score was a 15 with a 10% chance of recurrence if I took Tamoxifen. The reason why I agreed was he felt it would not only protect me from a recurrence, but he felt it would protect me from a future NEW breast cancer. That seemed like a good enough reason for me to try it.

  • katiekabooom
    katiekabooom Member Posts: 10
    edited May 2012

    @Stena3912  Hi! thought I would chime in here as I'm relative new on Tamoxifen -- started in December 2011.  Before I went on it, I was dreading it -- the hearsay on the side effects sounded worse than anything I had been through.  I was convinced I did not want to take it.  Even when I got my Oncotype results back and taking the Tamoxifen would reduce reoccurance by +5% I was opposed.  I agreed with my MedOnc and husband to give it a try though, and see how the drug affected ME.  Turns out it was a complete non-event, I had NO side effects at all from the drug -- weirdly, I've even dropped a little weight :-)

     So, I'm inclined to recommend everyone try it -- dont commit to staying on it for 5 years initially, just try it and see how it affects your body and THEN decide.  All the best, whatever you choose. 

  • stayinhappy
    stayinhappy Member Posts: 25
    edited May 2012

    I am 43 and have just been diagnosed with mucinous breast cancer. I am taking Tamoxifen now, pre-surgery, in hopes that it will shrink the tumor.   I am weighing treatment options.  So happy to find this thread.  Would love to hear more about your treatment plans and how you came to decide/be directed in that regard. 

    My surgeon and oncologist have given me options of lumpectomy with radiation, or bilateral mastectomy.  I have family risk factors, though the BRCA test was negative.  Both my mother and maternal grandmother had breast cancer later in life but were successfully treated. My mom is going on 10 years cancer free.

    Just struggling about whether I should undergo double mastectomy, or if that would be an overreaction. Scary stuff.

  • voraciousreader
    voraciousreader Member Posts: 3,696
    edited May 2012

    Stayinhappy...Sorry to hear about your diagnosis.  I'm sure it must give you great comfort that both your mother and grandmother did well, despite a breast cancer diagnosis.

    Regarding your question about having a lumpectomy or BMX, you might want to check out some of the other threads here at breastcancer.org.  Many women have agonized over the decision.  Two years ago when the NY Times published a study regarding more women requesting BMX, there were hundreds of comments.  That shows how DIFFICULT of a decision it must be for many, many women.  Have you had the Oncotype DX test done on your tumor?  If so, what was the recurrence score?  Interesting that your doctor is doing the Tamoxifen pre-surgery to shrink the tumor and to see how well you respond to therapy.

    I wish I could offer more in the way of information that could help you make an informed choice about whether or not to do a lumpectomy or BMX, but I don't.  Perhaps, like I mentioned, one of the other threads might help you to ultimately make the right decision FOR YOU.

    Good luck and keep us posted.

  • voraciousreader
    voraciousreader Member Posts: 3,696
    edited May 2012

    Oh...and one more thing...regarding my decision to do a lumpectomy....the breast surgeon thought he could get excellent margins and a good cosmetic result with the lumpectomy...so we really didn't discuss anything else.  It seemed very straight forward. 

  • stayinhappy
    stayinhappy Member Posts: 25
    edited May 2012

    Thank you for writing VR.  My doctor is submitting for the Oncotype DX.  I will ask about his opinion as to whether he feels he could get good margins. I will also peruse some of the other threads for discussion on MBX/lumpectomy. I am really having a tough time with this.  I have, hopefully, 40+ years to live with my decision. No wonder it feels a bit overwhelming. All treatments come with some significant long term costs.  However, I feel very fortunate to have the luxury of options.  I know many don't.  God bless them.

    Curious - Have you pursued lifestyle and diet changes said to be anti-cancer? Or any alternative measures?  What have you learned about the effectiveness of such measures? Read about diet, supplements, anti-toxicity (chelation), etc.  Wonder if any of it really makes a bit of difference when used in conjunction with traditional medical treatments (which I will absolutely pursue).

    Like others, I must say how much I appreciate your informative and well-researched posts.  So very helpful.  Thank you.

  • topless
    topless Member Posts: 23
    edited May 2012

    I had a 2.8 cm pure mucinous invasive cancer and I agonized over what to do and railed at a medical establishment that made women make these medical decsions without benefit of a medical degree. We are left to surf through reams of info on the internet, trying to decide what is quackery and what is sound science, and communicating with unknown entities in chat rooms and on forums, hopeing to gain some insight on what they should do.  All this under the gun of makeing the decsion in "the next week or two".  Because I have other health issues I finally just threw in the towel and decided to have a BMX and be done with it.  I'm glad I did.  But it seems a poor way to make life-changing descions about one's future.

  • voraciousreader
    voraciousreader Member Posts: 3,696
    edited May 2012

    Stayinhappy...I have made no changes whatsoever in my lifestyle or diet. I come to this journey from a very different perspective. The DH has a very rare genetic metabolic muscular dystrophy. Under the care of world class physicians and dietitians, we have lived a very healthy lifestyle for decades. Likewise, I see how fascinating small manipulations in his diet sometimes improves his condition, while at other times it doesn't. Along with a dozen other brave people who are participating in a clinical trial, he takes an oil similar to Lorenzo's Oil. I sincerely believe if there was a Lorenzo's Oil for our condition, we all would be receiving it. Furthermore, both my mother and sister are morbidly obese, engage in an unhealthy lifestyle and have multiple chronic diseases. But guess who got the breast cancer? Me!



    So, I am very pragmatic. Show me the evidence and MAYBE I would consider manipulating my already healthy diet and lifestyle.



    I'll leave you with this one last thought. One of my dearest friends and I take 3 mile walks together on a regular basis. She has a Ph.D. in pharmacology. She is also Indian. Despite living a healthy lifestyle, she suffers from diabetes. While we engage in our long walks, we pick each other's brains, trying to understand each new development in Eastern and Western medicine and all points in between! Yet when we return home, we are never closer to understanding how each of us got on our journeys, nor can either of us understand what more either of us can do to extend our lives... But nothing stops us from doing our research and then taking our long walks and wondering...

  • stayinhappy
    stayinhappy Member Posts: 25
    edited May 2012

    Enlightening VR. Topless, it is a hard decision. Good to know you are confident you made the right choice under pressure. Best to you both.

  • tricianneAust
    tricianneAust Member Posts: 153
    edited May 2012

    Hi just updating all the women here I need to pray for. Stayinhappy, sorry that you have reason to join us but I know the support given is just so usefull, you are now on my list to keep all of you covered with prayer for helpful decision making. good healing, improvement in health and courage to cope with the journey. Topless you are so right about having to make immediate decisions often based on limited medical knowledge & minimal understanding. I was confident that my breast surgeon who had done a double mastectomy on my stepmother then aged 75, 12 years before, recommended that with my diagnosis, its early detection, and excellent margins he considered that a lumpectomy was the automatic course of action. I am more than satisfied with the results. The Tamoxifen also appeared to fit my situation when I read up all the pros and cons. There is no wisdom in hindsight only full knowledge and understanding, anyone can get it right in retrospect, its all of us who have to make hard decisions often in a short time who need good advice, clarity of thought and lots of current wisdom. So blessings on you all.

    In answer to the healthy lifestyle, I was pretty healthy with diet etc before but do eat more organic veges & fruits, I have always grown what I can but now I pay more and buy organic too, just in case it helps. VR thanks for your always useful info, why have I never thought to include your DH on my prayer list I can easily put him in too!

    TricianneAust Dx 10/20/2010, DCIS, Pure Mucinous Cancer, 2cm, Stage I, Grade 1, 0/3 nodes, ER+75% /PR+ 75%, HER2-. Lumpectomy,Tamoxifen,25 x radiation, Vit D deficiency being treated. Feeling fantastically normal & healthy.Nov 2011 Mammogram all fine.

  • KnBsAngel
    KnBsAngel Member Posts: 6
    edited May 2012

    I am 42 and was just recently diagnosed with mucinous breast cancer.  Traveled to MD Anderson as I wanted best care (I live in a smallish city).  All tests and scans showed no mets to liver, bones or lungs. But they did find 3 axillary nodes and 3 infraclavicular lymph nodes looked as if they were cancerous.  They biopsied 1 axillary node and it is positive for the mucinous cancer.  Was wondering if anyone here knew anyone that has had it in lymph nodes to this extent?  My MO has started me on Tamoxifen as  I am ER + 100% and PR + 90% and HER2-.  I've pretty much decided on BMX (even without the results from genetics testing).  And I know I will have to have rads, but MO still wasn't positive about chemo.  I've been trying to read everything I can on mucinous BC and find very little with regard to lymph nodes.  I have become really stressed over the possible chemo, does anyone know how well hormone fed cancers really respond to chemo?  I've seen once it reaches lymph nodes most all have to have chemo but with it being mucinous and hormone would it still be necessary?

  • voraciousreader
    voraciousreader Member Posts: 3,696
    edited May 2012

    KnBsAngel...Sorry to hear about your diagnosis.  The only current research done on chemo with respect to mucinous breast cancer is this study from January 2012 regarding Neo-adjuvant chemotherapy:

    Breast. 2012 Jan 23. [Epub ahead of print]

    The differences in the histological types of breast cancer and the response to neoadjuvant chemotherapy: The relationship between the outcome and the clinicopathological characteristics.

    Nagao T, Kinoshita T, Hojo T, Tsuda H, Tamura K, Fujiwara Y.

    Source

    Department of Breast Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.

    Abstract

    Although effective regimens have been established for invasive ductal carcinoma-not otherwise specified (IDC), the efficacy and prognosis of other minor types of breast cancer are unknown because of their rareness. The clinicopathological features and prognosis of other minor types concerning the response to neoadjuvant chemotherapy (NAC) were evaluated in this study. A total of 562 patients were classified according to the Japanese and the World Health Organization (WHO) classifications, and the number of IDC and other special types (SP) was 500 and 62. The SP patients had a significantly poorer clinicopathological response to NAC and less breast-conservative therapy than those with IDC. According to the WHO classification, mucinous carcinoma, metaplastic carcinomas and apocrine carcinoma also responded poorly, and patients with metaplastic carcinomas and invasive lobular carcinoma had a significantly poorer prognosis. Despite the poor response to chemotherapy, patients with mucinous carcinoma and apocrine carcinoma had a good prognosis. The response to NAC and the prognosis vary for each histological type. For some types, the prognosis was not related to the clinicopathological response to NAC.

    BACKGROUND:

    In the treatment of breast cancer, neoadjuvant chemotherapy (NAC) has become the standard treatment modality for downstaging purposes. Although effective regimens have been established for the treatment of invasive ductal carcinoma-not otherwise specified (IDC), the data about the efficacy and prognosis for patients with other minor types of breast cancer are insufficient because of the rareness of these tumors. Defining the relationship between each histological type and the clinicopathological response to NAC is essential to optimizing individualized treatment.

    METHODS:

    We retrospectively evaluated the clinicopathological features and classification of the histological types based on the Japanese and the World Health Organization (WHO) classifications before and after NAC in 562 patients with primary breast cancer who underwent curative treatment after NAC between 1998 and 2008. The prognosis was estimated for each histological type.

    RESULTS:

    Of the 562 patients, the number of cases of IDC and other special types (SP) was 500 and 62. In the SP group, the clinicopathological response to NAC was significantly poorer, and the patients underwent breast-conservative therapy less frequently than did the IDC patients. According to the WHO classification, mucinous carcinoma, metaplastic carcinomas and apocrine carcinoma responded poorly to NAC. The disease-free survival and overall survival were significantly worse for patients with metaplastic carcinomas (p < 0.001 and p < 0.001) and with invasive lobular carcinoma (p = 0.03 and p < 0.001) than other cancers. Despite their poor response to treatment, patients with mucinous carcinoma and apocrine carcinoma had a good prognosis.

    CONCLUSIONS:

    The response to standardized NAC and prognosis varies for each histological type. For some types, the prognosis was not associated with the clinicopathological response to NAC. Innovative regimens should therefore be investigated for each histological type to achieve the best response.

    Copyright © 2011 Elsevier Ltd. All rights reserved.

    ________________________________________________________________________________________

    Perhaps you can show this study to your physicians.

    I wish you well.  Please let us know how you are doing.

  • Golden01
    Golden01 Member Posts: 527
    edited May 2012

    Please know you are in my thoughts as you make these hard decisions. You are getting world-class advice by traveling to MD Anderson.

  • stayinhappy
    stayinhappy Member Posts: 25
    edited May 2012

    KnBsAngel (others) -

    Would the Oncotype DX test determine if chemo would work in your particular case? My doctor has submitted for this.  Just wondering how accurate the test is in determing potential effectiveness of chemo for this unusual type of cancer.

    I can't thank all of you enough.  Though I didn't plan to be a memember of this club, I am so thankful for it.  You ladies give me strength and courage, along with a wealth of really good information. 

  • voraciousreader
    voraciousreader Member Posts: 3,696
    edited May 2012

    Stayinhappy...you ask an excellent question regarding how valid is the Oncotype DX test for our type of breast cancer vs IDC-NOS. If you scroll back on this thread, you will see, if you haven't already, that the folks who make the Oncotype DX test continue to follow scores for the more rare types, like our type and publish those data. So far, the average Oncotype DX score for mucinous is in the 15 range and is holding steady since they received marketing approval from the FDA. Interestingly, in 2011, the NCCN breast cancer treatment guidelines began recommending it for many early stage ER+ breast cancers. Notably absent from the recommendation was Tubular and Mucinous. Could it be because the prognosis is more favorable? Could it be because the test is not as strongly validated? I don't know. My doctor did the test for me, but felt my chance of recurrence was lower than what the score predicted. Not sure if he is correct.



    But the most important question that isn't being answered, is how effective IS chemo for our type of BC? Remember, chemo is more effective on grade 3 tumors than it is on grade 1 tumors, which many mucinous tumors are. I think that's one of the reasons why the MD Anderson doctor isn't quite sure yet what to recommend.



    Likewise, the study that I posted yesterday, speaks to the issue of how effective chemo is for our type as well. I think it is a seminal article that begs for more research, because we need an answer to the question, how effective IS chemo for our type? If you read the conclusion of the study it recommended "innovative regimens" should be investigated for the rare types.



    I hope they will!

  • Kurorin
    Kurorin Member Posts: 12
    edited May 2012

    Hi,

    I am new to this board and am glad to find there are others who have Mucinous Carcinoma.  However, nobody has posted anything since Feb of 2010.  I am hoping my posting may bring this back to active topic...

    I am 39.  I went for an excisional biopsy in April just to get rid of the lump I found in March (Mammo and Ulrasound showed it was most likely fibroadenoma.)  At a followup appointment Dr told me it was cancer, so I went back to OR for SNB and to clear margin on May 11.  Node came back clear but margin was not (high grade DCIS).  I will be going for Mastectomy next.  Also, Oncotype test is being done to figure out what treatment to follow.

    Regardless of whether this topic stays inactive, I am glad I found this website and will be checking in to learn more~

    Thanks