J Korean Soc Magn Reson Med.  2010 Jun;14(1):21-30. 10.13104/jksmrm.2010.14.1.21.

Imaging Features of Mucinous Breast Carcinoma

• Han HJ
• Kim SH
• Cha ES
• Kim HS
• Kang BJ
• Choi JJ
• Lee JH
• Lee AW

• KMID: 1782990
• DOI: http://doi.org/10.13104/jksmrm.2010.14.1.21

Abstract

PURPOSE
To examine the imaging findings of mucinous breast carcinoma and to evaluate the difference in these findings based on the histopathologic grade.
MATERIALS AND METHODS
We retrospectively analyzed the imaging features according to BI-RADS in 29 patients with surgically proven mucinous carcinoma. The histopathologic grade was classified as well-differentiated, moderately-differentiated and poorly-differentiated. Based on these criteria, the differences in imaging findings were statistically analyzed.
RESULTS
Mammography was available in 20 cases, which contained 17 mass lesions (85%) and 3 cases of normal findings. On ultrasonography (27 cases), mucinous carcinoma was observed as a mass with an oval shape (59.3%), a microlobulated margin (55.6%) or an inhomogeneous isoechogenicity (74.1%). On MRI (21 cases), mucinous carcinoma was commonly observed to have a lobular shape (76%), smooth margin (86%) or heterogeneous contrast-enhancement (61.9%). On the kinetic curve, there was a delayed wash-out pattern (52.3%). There were no significant differences in the imaging findings for each histopathologic grade except that a well-differentiated tumor had an abrupt interface.
CONCLUSION
A well-differentiated mucinous carcinoma tended to have an abrupt interface on ultrasonography, as compared with the moderately-differentiated one. Mucinous carcinoma showed a heterogeneous enhancement and a delayed washout kinetic curve pattern on dynamic MRI.

Keyword

Adenocarcinoma, mucinous; Breast neoplasms; Mammography; Ultrasonography; Magnetic resonance imaging (MRI)

MeSH Terms

Adenocarcinoma, Mucinous
Breast
Breast Neoplasms
Humans
Mammography
Mucins
Retrospective Studies
Mucins

Figure

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  Fig. 1 Left mucinous carcinoma in a 54-year-old woman. (a) Mammogram showed a lobular, circumscribed, isodense mass without calcifications. (b) Ultrasonography showed an oval, microlobulated, heterogeneously isoechoic mass with posterior enhancement and abrupt interface.

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  Fig. 2 Right mucinous carcinoma in a 41-year-old woman. (a) Ultrasonography showed an oval, microlobulated, complex echoic mass with posterior enhancement and abrupt interface. (b) Axial T2-weighted image showed a hyperintense, lobular mass with a smooth border. (c) Axial contrast-enhanced T1-weighted image showed rim enhancement. (d) Kinetic curve showed the delayed washout pattern. (e) Mucinous carcinoma consisted of hypocellular areas with large lakes filled with mucin and sparse clusters of tumor cells (black stars), and hypercellular areas with crowded clusters of tumor cells in the mucin (black arrowheads) (Hematoxylin-eosin; magnification ×40).

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  Fig. 3 Left mucinous carcinoma in a 52-year-old woman. (a) Ultrasonography showed an irregular, microlobulated and heterogeneously isoechoic mass with posterior-enhancement and an echogenic halo (white arrowheads). (b, c) Axial and sagittal contrast-enhanced T1-weighted image showed an oval, heterogeneously enhancing mass with irregular margin. (d) Mucin pools of variable sizes were separated by fibrous septae (black stars) and clusters of tumor cells floating in the mucin pools (Hematoxylin-eosin; magnification ×40).

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