Aug 8, 2019 07:39PM obsolete wrote:
Alderaan and Phg01161, Hello and welcome to our M.C. group. I'm very sorry that you have the need to be here. Please know that you ladies are not alone, even though we are small in number.
Your Invasive Mammary Carcinoma with Mucinous Features is sometimes a diagnosis similar to mixed mucinous, which is most often mixed with a certain % of conventional IDC. Unfortunately, not all Breast Pathologists are trained alike nor do the pathologists get into the nitty gritty with the patient on their tumor's molecular subtype (phenotype Luminal A vs. Luminal B, etc.), which, IMHO, is also important.
As VR stated earlier, surgical & treatment options are a personal decision. You may be interested in reading the following. Best wishes to all who are navigating this complicated rare disease!Mucinous Breast Cancer Should Not Be Undertreated https://www.medscape.com/viewarticle/714088
Some recent research has suggested that, in cases of mucinous carcinoma,
a certain percentage of women will have more than one mucinous tumor in
the breast. For example, a 2009 study at M.D. Anderson Cancer Center
found that, in a sample of more than 260 women with mucinous carcinoma,
about 38% had more than one area of cancer within the breast. Research
is ongoing, but you may want to discuss this information with your
doctor and see what he or she recommends." https://www.breastcancer.org/symptoms/types/mucinous/treatment
Mucinous Breast Carcinoma: Occult Multifocality/Multicentricity in a Favorable Disease
Purpose: Mucinous carcinoma is a
distinctive tumor that reportedly has a very favorable prognosis.
Accordingly, investigators have recommended that patients be treated
with minimal effective therapy rather than maximum tolerated treatment.
However, previous reports have been limited by small sample sizes and
very short follow-up intervals. We have previously reported outcomes for
a mature data set with long term follow-up and now perform the current
analysis to emphasize comprehensive multidisciplinary management in an
era of minimal effective therapy for so-called favorable disease.Methods and Materials:
We retrospectively reviewed charts for 264 patients with a pure
mucinous carcinoma diagnosis at our institution from 1965-2005.
Multidisciplinary management is emphasized for all patients at our
institution including this patient cohort. All pathology was centrally
reviewed. Overall survival, DM-free survival, and local-regional control
were compared using Kaplan Meier method and log rank statistics.Results:
Median age was 57 years (range 25-89). Median follow-up was 168 months.
86% of patients were stage T2 or less. Patients who were lymph node
negative compared with 1-3 LN+, or 4 or more LN+ were 80%, 15%, and 5%
respectively. 44% received BCT while the remainder underwent mastectomy.
51% of all patients received XRT. No patient in this cohort received
partial breast irradiation. 10% of patients had an initial
multicentric/multifocal presentation. However, a detailed pathology
review revealed a 38% multifocal/multicentric disease rate after
surgical resection. The occult tumors were not initially detected by
mammography or ultrasonography.5, 10, and 15 year OS, DMFS, and LRC
rates for all patients were: 95%/88%/83%; 97%/95%/92%; and 97%/94%/85%
respectively. There was no statistically significant difference in OS,
DMFS, or LRC based upon surgical management by mastectomy in comparison
with BCT. Likewise, there was no statistically significant improvement
in OS or DMFS with utilization of whole breast XRT. There was, however, a
trend for improved LRC in patients who received XRT (p=0.06) in
comparison with patients who underwent mastectomy or BCT without XRT.Conclusions:
This large series of patients diagnosed with pure mucinous breast
carcinoma demonstrates potentially favorable prognosis. However, this is
the first known report of an association with significant occult
multicentricity/multifocality. In an era of minimal effective cancer
therapy which includes no additional treatment post resection in
favorable histology, and partial breast XRT in favorable histology,
multidisciplinary management inclusive of pathology and diagnostic
imaging is recommended. Current treatment guidelines should reflect that
before omitting whole breast XRT, patients should have pathologic and
radiologic intraoperative correlation and MRI should be a consideration
in efforts to identify potential occult disease.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4117.