Mucinous Carcinoma of the breast
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Hi Krystin, so sorry about your loss, & it's a crapshoot you now find yourself here. Hopefully you're healing well, and glad you made a good surgical choice, considering your family history. My experience was different, but I'm wishing you well without any further advice other than to suggest you take things slow & easy. Take care.
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Hi Krystin, so sorry about your loss, and sorry you now find yourself here. MC is a crapshoot, but I think you made the right surgical choice under your circumstances. There's never a wrong choice because everyone is different. Please take it slow & easy thru your healing process. Best wishes
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Neovascularization In Mucinous Ductal Carcinoma In Situ Suggests An Alternative Pathway For Invasion
S A Gadre et al. Histopathology. 2008
https://pubmed.ncbi.nlm.nih.gov/18983463/
Precursor Lesions Of Mucinous Carcinoma Of The Breast: Analysis Of 130 Cases
Oleksandr N Kryvenko et al. Am J Surg Pathol. 2013 Jul.
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Mucinous carcinoma of the breast: Diagnosis and management of an unusually young patient
Published online 2022 Mar 2
"...in the case of mixed-type mucinous carcinoma they require more frequent chemotherapy adjuvant (31.6% vs 7.4%, P < .001), and undergo more mastectomy (32.9% vs 11.1% P < .001) than those of the pure subtype."
"The decision to treat a patient with mastectomy depends on her category..., may or may not require radiotherapy, this will depend on whether the patient has a tumor with deep margins or lymph node involvement. However, radiotherapy has NOT shown a significant difference in the overall survival of patients with mucinous carcinoma of any subtype."
"Systemic hormonal neoadjuvant treatment will depend on the characteristics of the tumor, especially aimed at locally advanced tumors."
Reported 10-year survival for pure tumors is 87%-90% and that of the mixed subtype is 54%-66%... Although the benign appearance of mucinous carcinomas on mammography can cause a delay in diagnosis, it is also true that they have a FAVORABLE PROGNOSIS, as they are low-grade, slow-growing tumors that rarely metastasize. The largest cohort of this type has shown that the prognostic factor continues to be lymph node involvement, followed by age, tumor size and having hormone receptors."
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Everybody, Praying for Peace, adequate food supplies and good health for all 🙏
(2022) "Mucinous Breast Carcinoma"
Continuing Education Activity:
"Transcriptomic studies have demonstrated that mucinous tumors are of Luminal A molecular subtype [4]. The transcriptomic features of mucinous A are distinct from those of mucinous B tumors, the latter showing a pattern of gene expression that is similar to that of neuroendocrine carcinomas [4]. Pure mucinous carcinomas harbor a low level of genetic instability and rare recurrent amplifications, and the genomic profiles of the tumor components of mixed mucinous tumors are remarkably similar to those of pure mucinous carcinomas. More than 90% of pure mucinous carcinomas are diploid, whereas only 42% of mixed mucinous carcinoma are diploid [5]."
"Typically, mucinous carcinoma is positive for estrogen and progesterone receptors [9], while androgen receptors are expressed at a low level, and HER2 is not amplified [10]. Pure and mixed mucinous carcinomas are reported to express WT [11]. Mucinous breast carcinoma expresses predominantly MUC2 and MUC6 among the family of MUC genes [12]."
"General health status: Higher prevalence of comorbidity, frailty, and cognitive decline in elderly patients are considered limiting factors when selecting treatment."
"Axillary lymph node metastases occur in 12% - 14% of the cases [19]."
"Late distant metastases may occur in pure mucinous carcinoma [21]."
"Other studies have found that tumor size is not a significant prognostic factor and does not affect survival since most tumor volume consists of mucin."
"Complications of breast mucinous carcinoma include:
-- Axillary lymph node metastases
-- Late distant metastases
-- Recurrence after surgical excision"
"After treatment of mucinous breast carcinoma, long-term follow up is necessary to detect local and distant relapse. [Level 5]"
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Mucinous Cystadenocarcinoma Of The Breast: A New Entity With Broad Differentials-a Case Report
Kanwalpreet Kaur et al. J Egypt Natl Canc Inst. 2022.
"Mucinous cystadenocarcinoma is a rare and recently described primary breast cancer with strikingly similar histomorphology to ovarian, pancreatic, and gastrointestinal counterparts... strong membranous HER2-protein expression and HER2-gene amplification ... in literature this tumor is reported to show mainly triple-negative basal type immunophenotype."
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Mucinous Breast Carcinoma Metastatic to Thyroid Gland: Report of A Case Diagnosed By Fine-Needle Aspiration Cytology
"woman who had breast cancer 13 years ago was diagnosed as thyroid metastatic mucinous breast carcinoma, cellular variant with neuroendocrine differentiation. For this patient, the thyroid was the only involved site."
https://khepri-node.dev.meta-infra.org/papers/muci...
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Attention: those Mucinous patients who test high risk and/or Luminal B phenotype in assays, you may find this thread helpful...
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Thanks for the reading, Obsolete. I am joining you in praying for PEACE, necessary supplies, heallinag and health.
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Hello marvelous mucinous members! Quick update on my progress. I had surgery in Seattle on 2/24/22. All went well with breast conserving surgery and 3 lymph node removal. The pure mucinous tumor was less than 10 mm across and minor in situ ductal carcinoma was discovered. My team at Seattle Cancer Care Alliance was fabulous and I was back in Anchorage on March 8. I am doing some PT and start set up for radiation tomorrow here. I will have 16 sessions and will be on an aromatase inhibitor for five years max.
Thanks for all the advice and well wishes from many of you. I went into my appointments SO much better informed and knew the right questions to ask and how to be a part of my own treatment. By the way Nordstrom has a really great supportive bra that hooks up the front that I got while in Seattle. The brand is Amoena. I bought two in Seattle and they are available in white and nude online. Better than the Fruit of the Loom cotton ones I got on Amazon. I still wear those but they are not nearly as supportive and compressive after surgery. During radiation I will probably use the Fruit of the Loom cotton ones as they are softer material.
Best to all, BooBoo!
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Booboo, I'm so happy that everything went well with your lumpectomy and that you got a good path report! Radiations will be easy and I hope you will tolerate well the AI. Thanks for the update and all the best going forward! ♥️
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Hello Canada & Alaska, best wishes for healthful healing to Boo. Friendly springtime 🌼 greetings to Rain and hoping everyone has a pleasant season. Peace 🕊️ & good intentions 🙏
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CONSTRUCTION OF A PROGNOSTIC NOMOGRAM MODEL FOR PATIENTS WITH MUCINOUS BREAST CANCER( (2022)
"... there is a lack of reports of large sample studies on MBC, which predisposes to under-treatment or over-treatment."
"Univariate analysis of the survival of 2,776 MBC patients in the modeling group revealed that the 3- and 5-year survival rates of patients were linked to their age, ethnicity, marital status, T stage, N stage, M stage, surgery, radiotherapy, and chemotherapy, but NOT to histological grade, lesion location, PR status, ER status, or HER-2 status as indicated in Table."
"... age at diagnosis is the greatest contributor to the prognosis, followed, respectively, by M stage, TNM stage, ethnicity, surgery status, and radiotherapy status. The nomogram shows that the use of radiotherapy is beneficial for patients with MBC."
"... only lymph node involvement is considered chemotherapeutic, regardless of the T stage."
"Furthermore, lymph node involvement was found to be unrelated to tumor size in one investigation."
"It has been shown that patients treated with breast-conserving surgery in stage T1-2 MBC have a better prognosis than those who undergo mastectomy, particularly in patients aged 50–79 years;"
"In the current study, a total of 2,043 (51.5%) patients received radiotherapy and 1,921 (48.4%) did not. The nomogram shows that the use of radiotherapy is beneficial for patients with MBC."
"It has been reported in the literature that the reason for the low efficacy of chemotherapy is that mucus accounts for most of the total volume in MBC cells, forming a large pool of mucin, resulting in inconsistency between clinical or imaging assessment of chemotherapy efficacy and mucinous carcinoma pathology. Despite the effective elimination of malignant cells by chemotherapy, the mucin pool remains."
https://downloads.hindawi.com/journals/jhe/2022/12...
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Thank-you Obolete for all the information you share. This last article is really significant, I am making a copy to give to my first oncologist, he needs to be educated! My second oncologist was up to date on Pure Mucinous Breast Cancer .
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I had Mucinous carcinoma that was extracted. Now the doctor recomended the radioterapy plus Ovarian suppression combined with tamoxifen. Any expirience in not taking the Ovarian suppression and combined with tamoxifen?
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Hey Fran. You must be pre-menopausal? I was too. I had chemo then radiotherapy, and now I'm doing ovarian suppression combined with Exemestane (so an AI rather than Tamoxifen). The side effects have been present but very manageable. The main factor for me is being unable to have children naturally, but I'd rather stay on the meds and avoid recurrence. Tough decision but that's the direction I decided on. Happy to answer any questions you may have. What is making you think of declining the ovarian suppression?
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Hello, fellow ladies, Thought I'd post an update, as I had been referred back to my GP, after 3 years with my onco team. (I live in Canada, Ontario, and this is standard procedure here.) I am doing well, no longer on Tamoxifen, as I had to stop taking due to VB. My MO advised against AI, as benefits from it were deemed minimal, compared to possible side effects, with 1% survival at 10 years and 2-3% recurrence risk at 10 years. So, 3 years later, cancer is still on my mind every day, but more as a faded sort of thought, as opposed to my mind being fixated on it. I am back to working full time (I'm 51 yo) and looking forward to celebrating Thanksgiving. This year's Thanksgiving comes with the 25th anniversary of my marriage and the 24th BD anniversary of my older son!!! I hope everyone is doing well. Sending you all hugs and heart felt wishes of health and well being.
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Hi, Thanksgiving greetings to RAIN88 & our Canadian sisters. Happy 25th too! Yes, many of us count blessings, but also continue to keep looking over our shoulders. Given there are (4) Stage-IV mucinous sisters currently active on this forum, we 🙏 for their endurance & strength. It's not easy to erase our own MC past, but living in the present helps to keep things real and in perspective.
I'm also under primary care MD, but a Naturopath suggested Brevail as a gentle natural breast supplement post- Tamoxifen or after AI's. I failed both with QOL & blood clotting complications.
Recent hurricane storm damage from hurricane Ian helps me to keep things in perspective. We evacuated, but grateful we still have a home. Water & electricity back on this weekend, home cleanup from wind, door & window blowouts, roof destruction, flooding & fallen trees is a continuous community effort. Blessings 🙏 to those who lost homes & lives. Grateful for the disaster relief efforts. Thanksgiving this November in Florida & the South will be meaningful. Congratulations on reaching your yearly milestones. Hope 🕊️ Peace 🕊️
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I think and hope a lot of us MBC sisters are still around, sharing our journeys . Mine has been since 9/23/16, still, and seems always in the back of my mine…..Let's stay together even though, of the tremendous disappointment in this site.!
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Effect of postoperative radiotherapy in women with localized pure mucinous breast cancer after lumpectomy: a population-based study
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Prognostic Impact of Radiation Therapy in Pure Mucinous Breast Carcinoma
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Voraciousreader, thank you for sharing. It was a coincidence that I have just read an article about secondary breast cancer as a result of RT and was beginning to wonder about the soundness of undergoing it...
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rain...
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Hi everyone
This was my former dx in 2012 Invasive or Infiltrating Ductal Carcinoma (IDC) Right, 3.2 cm, Stage IIB, Grade 3, Some/1 nodes ER+,PR+, HER2- I had a double mastectomy, a DIEP, with chemo and radiation to right breast. Been in remission for 10 years.
I have lung nodules dx in 2018. a 9mm in left lower, a 4mm and a 8mm in upper left lobe, a 1.1cm in lower left lobe at the costophrenic sulcus. They took out the left lower lobe nodule during the surgery. They were all watched closely with CT scans since 2018. Surgery on Oct 11, 2022. determined to have Carcinoma with Mucinous feature as metastatic breast cancer. New Pathology: Oct 11, 2022 Estrogen Rec Pos (>95%), Progesterone Rec Pos (60% moderate to strong) HER2/NEU Equivical (2+) GATA3 Pos GCDFP-15 Neg. Mammaglobin Pos TTF-1 NegHER2 in progress and will be reported separately.
I am told it is slow growing. I have a friend who rec a Cyberknife to go get the other there nodules while they are small to stay ahead of this disease. Anyone out there with a similiar situation? Rose
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I already posted however everyone here has initial mucinous carcinoma of the breast. I now have it in my lungs (nodules tested) and determined this cancer in the LUNG from the breast that have been removed since 2012 with a successful remission. Now, the only place seen is the LUNG? Anyone similiar?
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Hi Oropallo, so sorry you find yourself with advancing mucinous in your lungs. You're apparently one of the rarest cases.
Have you gone thru genetic testing yet? Your nurse navigator can guide you. It's also never a bad idea to obtain a second opinion pathology consultation. Johns Hopkins & MSK, I think, still conduct rare cancer research & have rare cancer labs who can guide you further.
Did your original mucinous pathology note transcriptomic features of Mucinous A or Mucinous B tumors?
Did your recent pathology show large cell clusters (hypercellular or type B mucinous carcinoma) with neuroendocrine differentiation?
What were your respiratory symptoms for lung mets? Please refer to the "Mets To Lung" thread for Stage-IV linked below.
https://community.breastcancer.org/forum/8/topics/...
Have you had a blood biopsy to determine your tumor's & lung node's reactions to specific chemo & immunotherapy? (For example, Foundation One labs blood biopsy)
As you'll read in links below, usually mucinous carcinoma can advance in bones first before organs. Also included are most recent links by 4 different Mucinous Stage-IV posters, so you can perhaps follow, post or contact them directly via private message. I think 2 mucinous gals in Stage-IV forum have lung mets and 2 have bone mets with node mets, etc . So you're not alone and we're all here for you. Hugs, all the best wishes & blessings to you.
https://community.breastcancer.org/forum/8/topics/...
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METASTASIS OF THE MUCIONOUS ADENOCARCINOMA OF BREAST TO THE MANDIBULAR GINGIVA: RARE CASE REPORT
https://journals.lww.com/md-journal/fulltext/2022/...
MUCINOUS CARCINOMA OF THE BREAST: DIAGNOSIS AND MANAGEMENT OF AN UNUSUALLY YOUNG PATIENT
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88991...
May 2022 NCBI Bookshelf report:
https://www.ncbi.nlm.nih.gov/books/NBK538334/
MUCINOUS CARCINOMA OF THE BREAST , Last revised by Dr Calum Worsley◉ on 18 Jul 2022
https://radiopaedia.org/articles/mucinous-carcinom...
PRIMARY BREAST MUCINOUS CYSTADENOCARCINOMA AND REVIEW OF LITERATURE
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC89973...
----- Stage IV Forum contributors ----
https://community.breastcancer.org/forum/8/topics/...
https://community.breastcancer.org/forum/78/topics...
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Hi again Oropallo, in response to your question, I didn't have anything similar to you except one tiny nodule in lung that's remained stable for 8-9 years. Also have a shotty enlarged hilar node with heavy ground glass opacities in both lungs (pneumonia scarring), but MD stopped repeating CT lung scans. Dx: benign, infection. Symptoms: intermittent SOB upon exertion sometimes. Had COVID long with secondary pneumonia. No further treatment from MD recommended, but seeing Naturopath. Aspirin 91mg, Vitamin C, B-12, E, K, Potassium Iodine, Broccoli Sprout Extract, CoQ10, Magnesium, Calcium, Brevail, Green Tea, grape seed extract, turmeric w/cayenne pepper & daily supplement suggested. Important to take liquid Vitamin D to maintain higher level. Hope this helps.
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Oropallo, I am so sorry you found yourself in this situation after such a long time since diagnosis. I hope you have been able to connect with others.
Obsolete, thank you for the wealth of readings. There seems to be more findings about invasive mucinous breast cancer, but the standard of care remains pretty much the same. A change I noticed is the age, as one of the articles I read stated that mucinous affects women between 47-70 yo. So that's been reviewed. There is still a lot to be learned I guess. I was very impressed with your message to Oropallo; how do you know so much?! Wishing you a beautiful fall season. ♥️
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Hey gals... Some of us have had our our scares & scans, right Rain? But BIOCEPT, FOUNDATION ONE, SIGNATERA or GUARDANT can screen blood for Circulating Tumor Cells (CTC). There's even an ongoing trial for testing metastatic BC patient's blood for CTC cells & CTC clusters.
Our pathologies are all on the Mucinous spectrum with varying degrees of tumour cellularity, mucin content & differentiation. Nurses claim with proper diet & exercise "Breast Defend' can help us to balance estrogen levels by lowering bad estrogen, but not the good estrogen required for vital organs. 🙏 Hugs & peace 🕊️
"It has been suggested that CTCs can be used to stage metastatic disease and characterize as indolent or aggressive." https://community.breastcancer.org/forum/8/topics/...
"SIGNATERA screening for circulating tumor cells... in a clinical trial, this test saw CTCs two full years before clinical signs of distant recurrence. This should give us a chance to treat before those tumor cells can grow into something more threatening." https://community.breastcancer.org/forum/69/topics...
https://www.sciencealert.com/breast-cancer-spreads...
https://www.sciencedaily.com/releases/2022/06/2206...
THE METASTATIC SPREAD OF BREAST CANCER ACCELERATES DURING SLEEP https://emedicine.medscape.com/article/1947145-ove...
"High shear stress caused necrosis in over 90% of circulating tumor cells within the first 4 h of circulation. More importantly, the CTCs that survived the first 4 h-circulation, underwent apoptosis during 16–24 h of post-circulation incubation." https://community.breastcancer.org/forum/8/topics/...
OMISSION OF CHEMOTHERAPY FOR THE TREATMENT OF MUCINOUS BREAST CANCER: A NATIONWIDE STUDY FROM THE KOREAN BREAST CANCER SOCIETY (2019). "Conclusion: Our large retrospective analysis revealed that ADJUVANT CHEMOTHERAPY provided LITTLE BENEFIT to improve the prognosis of most ER-positive MBC patients. Therefore, chemotherapy can be omitted in the treatment of most ER-positive MBC." https://pubmed.ncbi.nlm.nih.gov/31897333/
INVASIVE MUCINOUS CARCINOMA OF THE BREAST AND RESPONSE PATTERNS AFTER NEOADJUVANT CHEMOTHERAPY (NAC) -- 2018" Conclusions: Persistent mass-forming low-cellular or acellular mucin pools can result in discordant clinical, imaging and pathological findings in IMC treated with NAC." https://pubmed.ncbi.nlm.nih.gov/29220097/
THE BREAST: DIAGNOSIS AND MANAGEMENT OF AN UNUSUALLY YOUNG PATIENT (2022) "After 5 months, the patient completed neoadjuvant [chemo] treatment with a taxane phase, with a PARTIAL RESPONSE of 60%..." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88991...
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So true, Obsolete! ♥️
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Hello,all, just wondering if invasive ductal Carcinoma with neuroendocrine features is similar to the mucinous? Just trying to find out more info on my third diagnosis, all the same.
Thanks
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Hi Bennybear, so sorry you're on the 3rd round. It's tough to deal with 3 life changing events, but with experience brings strength & fortitude, it is said.
Out of curiosity, had you been given the latest experimental covid booster before your 3rd lesion had been found? ( I'm doing my own informal survey)
The way it had been explained is that NE can overlap with Mucinous Type B. NE can also present with IDC (NOS) as mixed.
Extra cellular mucin is also supposed to be common with NE whereby NE and MC-Type-B can sometimes join together or merge, if this is possibly what you're asking.
Your pathologist should be able to advise your neuroendocrine % content. But little is actually known about potential advantages of high NE involvement in these rarer subtypes of breast cancers.
Some quantity of NE cells can happen in Mucinous lesions, but not always in sufficient quantities for a 'differential" classification on your pathology.
Supposedly many pathologists don't bother looking with stains for NE, which is why numbers of NE are thought to be very much underestimated, which contributes to it's mystery.
Best wishes in your treatments 🕊️🤞
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