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Resumen OBJETIVO: Determinar la frecuencia y los hallazgos clínico-patológicos del carcinoma mucinoso de la mama. MATERIALES Y MÉTODOS: Estudio retrospectivo, observacional, descriptivo y transversal consistente en el análisis de los expedientes clínicos de pacientes atendidas en el Hospital de Ginecología Luis Castelazo Ayala entre el 1 de enero de 2009 y el 31 de diciembre 2016 con muestras quirúrgicas referidas por el servicio de Anatomía patológica con diagnóstico de carcinoma mucinoso de la mama. Criterios de inclusión: casos de carcinoma mucinoso de la mama. Criterios de exclusión: ausencia de registro de biopsia o de reporte histológico, carcinoma de la mama asociado con otro tipo histológico distinto. RESULTADOS: Se encontraron 64 casos de carcinoma mucinoso invasor de la mama. Promedio de edad: 61.9 años (límites 32 y 95). Diez pacientes se ubicaron en el grupo de 66 a 70 años y 8 en el de 41 a 45 años. Se registraron 49 casos de carcinoma mucinoso puro y 15 de carcinoma mixto, de éstos 9 correspondieron al tipo histológico ductal, 1 al tipo lobulillar, 3 al ductolobulillar y 2 de otra variante histológica. CONCLUSIONES: El carcinoma mucinoso es una variante rara del carcinoma invasivo del conducto mamario que aparece en mujeres de edad avanzada. El diagnóstico y el tratamiento oportuno son posibles mediante mamografía y confirmación histopatológica.
Abstract OBJECTIVE: To determine the frequency and clinicopathological findings of Mucinous carcinoma of the breast. MATERIALS AND METHODS: Retrospective, observational, descriptive and transversal study. Analyzed the clinical records of patients whose surgical samples were referred to the pathology Department of the Hospital of Gynecology Luis Castelazo Ayala with the diagnosis of Mucinous carcinoma of the breast, during the 01 of January 2009 to the December 31, 2016. Inclusion criteria all cases of Mucinous carcinoma of the breast and the exclusion of those who did not have record of biopsy or absence of histological report, carcinoma of the breast associated with another different histological type. RESULTS: 64 cases with invasive Mucinous carcinoma of the breast between 2009 and 2016 were reported. The average age was 61.9 years (32 to 95 limits). We identified 10/64 patients aged 66 to 70 years and 8/64 in the 41 to 45 years. There were 49/64 Mucinous carcinoma of pure and 15/64 mixed carcinoma, of which 9/15 corresponded to the histological type of ductal, Lobular type 1/15, 3/15 ductolobulillar and other histological Variant 2/15. CONCLUSIONS: Mucinous carcinoma is a rare variant of the invasive carcinoma of the breast duct that occurs in older women. It is possible to have a diagnosis and treatment using mammography and histopathological confirmation.
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Objective To evaluate the value of breast duct endoscopy and breast localization needle for the diagnosis and microinvasive treatment of intraductal lesions. Methods A total of 103 patients with nipple discharge without breast lumps were examined by breast duct endoscopy in our hospital. Of them, 63 cases of intraductal lesions were localized with breast localization needle and received arc incision of the areola of the breast and excision of the localized breast duct with 1-cm adjacent tissues, which were sent for intraoperative frozen. After the frozen pathological examination, the operation was ended for the patients with intraductal papilloma; simple mastectomy was performed on those with duct papillomatosis; and simple mastectomy combined with DIEP reconstruction was carried out for the patients with intraductal carcinoma. Results Frozen and postoperative pathological examinations showed single intraductal papilloma in 59 of the patients (59/63, 93.6%), duct papillomatosis in 2 (2/63, 3.2%) , and intraductal carcinoma in 2 (2/63, 3.2%). The 59 patients with single intraductal papilloma were reexamined in 3 months after the operation, none of them had nipple discharge or other symptoms. Conclusions Resection of intraductal lesions under the guidance of breast localization needle is less traumatic with good cosmetic outcomes. By using the method, high rates of complete resection and accuracy of pathological examination can be achieved.
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Objective To explore the value of breast-duct endoscopy-assisted epidural catheter-guided tumor localization in the resection of intraductal lesions.Methods A total of 45 cases of breast-duct endoscopy-confirmed intraductal tumor were enrolled in this study.After the depth and location of the tumor was determined,the endoscope was withdrawn and an epidural catheter was inserted into the duct with discharge at a same level to support the duct and guide the resection of the tumor.Then,the skin covering the nipple and areola were cut radially,and the diseased duct was resected under the guidance of a epidural catheter.Results The ductoscopy showed intraductal papilloma in 41 cases,multiple intraductal papillomas in 2,and papillomatosis in 2.In the 41 patients with papilloma,the diagnosis was confirmed pathologically after the operation in 39 cases(95%),while in the 2 patients with multiple papillomas and the 2 with papillomatosis,the identical rate was both 50%(1/2).The misdiagnosed cases included 2 patients with epithelial hyperplasia,1 with multiple intraductal papillomas complicated with atypical ductal hyperplasia and severe focal hyperplasia,and 1 patient with breast cancer.In all the cases,the shape of the breast and nipple were normal after the operation.Conclusion Breast-duct endoscopy-assisted epidural catheter-guided tumor localization is worth being widely used for resection of intraductal lesions in local hospitals,for its precise localization,simple procedure,and good cosmetic outcomes.