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Topic: Mucinous and Micropapillary

Forum: Less Common Types of Breast Cancer — Meet others with less common forms of breast cancer, such as Medullary carcinoma, Inflammatory breast cancers, Mucinous carcinoma (colloid carcinoma), Paget's disease, Papillary carcinoma, Phyllodes tumor, Tubular carcinomas, Metaplastic tumors, Adenoid cystic carcinomas and Angiosarcoma.

Posted on: May 10, 2020 08:47PM - edited May 10, 2020 11:12PM by Pinkywave

Pinkywave wrote:

Hi everyone. I posted the same post in the other thread but thought I'd get more responses here because of my type.

I have stage 2 breast cancer (T2, N0, Mx), grade 1, Ki-67: 0-5%. ER/PRpositive, HER2 negative. Diagnosed on 03/17/20, had lumpectomy on 04/21/20, negative lymph node but got positive margin. I was initially told that my tumor was 1.2cm but it turned out to be 4.3cm and besides my primary tumor (mucinous carcinoma, micropapillary : grade 1), they also found extensive DCIS (grade 1-2). So now I'm considering having mastectomy, hopefully skin-sparing mastectomy, but my surgeon says he only performs total mastectomy and if I want skin-sparing, he needs to refer me to someone else.......If I'm ok with total mastectomy, I can have it done in 10 days. I'd like to explore my options, but I certainly don't want my remaining cancer to spread. So my question is, how long is too long to wait to have re-excision after lumpectomy with positive margin?

Also, I know Mucinous carcinoma usually has good prognosis but how about when it's mixed with micropapillary? Does anyone have same condition as me? I'd like to know!! Thank you so much❤️

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May 10, 2020 11:05PM santabarbarian wrote:

I am not too aware of the specific cancer forms you have but I do know that a low Ki-67 and low grade (1) mean that your cancer is NOT fast-spreading. You definitely have time to get another opinion! Or a few of them.

I am sorry you are in this situation at all, but I see features of your cancer that are positive!

You need to know what the benefits and risks of each kind of treatment are. In your shoes I would talk to another MD who might have a different approach or opinion, and then see what feels right to you.

pCR after neoadjuvant chemo w/ integrative practices; Proton rads. Dx 7/13/2018, IDC, Left, 3cm, Stage IIB, Grade 3, ER-/PR-, HER2- (FISH) Chemotherapy 8/12/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 12/27/2018 Lumpectomy: Left Radiation Therapy 2/10/2019 Whole-breast: Breast, Lymph nodes
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May 11, 2020 05:20PM obsolete wrote:

Hi Pinky, very sorry you've found yourself in this difficult situation with very rare BC mixed sub-types. ( I also had multi-focal Mixed Mucinous Carcinoma, but also with Invasive Solid Papillary Carcinoma and DCIS grade III). Breast surgeons I had consulted with both had refused to perform a nipple-sparing because papillary invasive cells are said to be commonly found around & under the Nipple-Areola Complex area. The following is some food for thought:

"In conclusion, although nuclear grade may significantly influence the biological behavior of micropapillary ductal carcinoma in situ, micropapillary growth pattern per se represents a risk factor for local recurrence after breast-conserving surgery."

Here's one example of a male with micro-papillary infiltration into the Nipple-Areola Complex...

"...prevalence of malignant affection of the nipple-areola complex (NAC) in breast carcinoma patients and its correlation with prognostic factors for breast cancer..."

Mucinous Carcinoma thread has more information for you also on mixed micropapillary with MC...

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May 11, 2020 09:19PM Pinkywave wrote:

Hi obsolete. Thank you so much for your information. I’ll post in Mucinous Carcinoma thread to see if I can get more inputs. Thank you

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Jul 18, 2021 01:08PM Glevitan wrote:

I was originally diagnosed with mucinous breast cancer, and on further review of the pathology they have decided that it has a micropapillary component.

I had a lumpectomy, 2.5cm, additional DCIS, clear margins, 3 nodes negative, 1 node isolated cells.

I would love to hear about long term survival of this type of breast cancer. Thanks.

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Jul 20, 2021 05:23AM obsolete wrote:

Hi Glevitan,

The following may address your concerns, and it's good news if the mucinous tumor(s) were not mixed with conventional IDC and if they were molecular Luminal A subtype.

"Prognostic Significance of a Micropapillary Pattern in Pure Mucinous Carcinoma of the Breast: Comparative Analysis with Micropapillary Carcinoma"

For whatever it's worth, I've been in remission for 7+ years after having been diagnosed with multi-focal pure & mixed mucinous, the smaller of which had MicroPapillary features in tiny pure mucinous tumors. But my larger tumors were Grade 2 mixed mucinous (8mm + IDC) and Grade 2 Invasive Solid Papillary Carcinoma (3cm + IDC) with multiple areas of DCIS grade 3 scattered about. Hence, the reason I ended up with BMX.

Your best bet might be to speak with dedicated breast pathologists on these rarer types. I had been told mitosis index and molecular subtype (Luminal A vs Luminal B, for example) were key in our types of oddball BC subtypes. Best wishes.

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