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Indeterminate calcification and clustered cystic lesions are strongly predictive of the presence of mucocele-like tumor of the breast: a report of six cases

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Abstract

Mucocele-like tumor (MLT) of the breast is a mucinous disorder that is generally difficult to distinguish from mucinous carcinoma. Moreover, MLT is often accompanied by atypical ductal hyperplasia (ADH) or ductal carcinoma in situ (DCIS), and preoperative diagnosis is very confusing. In this paper, we summarize the clinicopathological characteristics of six cases of MLTs, comparing them with mucinous carcinoma. MLTs were characterized by clustered, coarse calcification on mammography and clustered, hypoechoic lesions with or without echogenic spots on ultrasonography. On fine-needle aspiration cytology (FNAC), three cases were correctly diagnosed and three cases were judged to be indeterminate, or insufficient material was present. Ultimately, excisional biopsies were performed to obtain a correct diagnosis in all cases. Immunohistochemical staining of MLTs accompanied by ADH or DCIS (malignant MLTs) revealed the presence of MUC6, while MLTs without ADH or DCIS (benign MLTs) were MUC6-negative. At present, as it is difficult to detect small areas of DCIS adjacent to the MLT by FNAC, excisional biopsy is essential. Immunohistochemical staining for MUC6 may be useful in differentiating between benign MLTs and malignant MLTs, although further investigation is needed.

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Abbreviations

MLT:

Mucocele-like tumor

ADH:

Atypical ductal hyperplasia

DCIS:

Ductal carcinoma in situ

FNAC:

Fine-needle aspiration cytology

MMG:

Mammography

US:

Ultrasonography

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Authors and Affiliations

  1. Department of Breast and Endocrine Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka Prefectural Hospital Organization, 1-3-3 Nakamichi, Higashinari, Osaka, 537-8511, Japan

    Koji Tanaka, Yoshifumi Komoike, Chiyomi Egawa, Kazuyoshi Motomura, Hiroki Koyama & Hideo Inaji

  2. Department of Cytology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka Prefectural Hospital Organization, 1-3-3 Nakamichi, Higashinari, Osaka, 537-8511, Japan

    Sachiko Nagumo

  3. Department of Pathology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka Prefectural Hospital Organization, 1-3-3 Nakamichi, Higashinari, Osaka, 537-8511, Japan

    Tatsuki R. Kataoka

Authors
  1. Koji Tanaka
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  2. Yoshifumi Komoike
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  3. Chiyomi Egawa
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  4. Kazuyoshi Motomura
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  5. Hiroki Koyama
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  6. Sachiko Nagumo
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  7. Tatsuki R. Kataoka
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  8. Hideo Inaji
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Correspondence to Koji Tanaka.

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Tanaka, K., Komoike, Y., Egawa, C. et al. Indeterminate calcification and clustered cystic lesions are strongly predictive of the presence of mucocele-like tumor of the breast: a report of six cases. Breast Cancer 16, 77–82 (2009). https://doi.org/10.1007/s12282-008-0058-8

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  • DOI: https://doi.org/10.1007/s12282-008-0058-8

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