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Mucinous Carcinoma
Jessica W. T. Leung, MD; Wendie A. Berg, MD, PhD, FACR, FSBI
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Mucinous carcinoma = colloid, gelatinous, or mucous carcinoma
            • Definitions

              • Uncommon subtype of invasive ductal carcinoma (IDC) characterized by large amounts of extracellular mucin
                • Pure type: ≥ 90% of tumor shows mucin production
                • Mixed type: Tumors with less extensive mucin = IDC with mucinous features

            IMAGING

            • General Features

              • Mammographic Findings

                • Ultrasonographic Findings

                  • Image-Guided Biopsy

                    • MR Findings

                      • Nuclear Medicine Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Chaudhry AR et al: Imaging features of pure and mixed forms of mucinous breast carcinoma with histopathological correlation. Br J Radiol. 20180810, 2019
                                              2. Pareja F et al: The Genomic Landscape of Mucinous Breast Cancer. J Natl Cancer Inst. ePub, 2019
                                              3. Didonato R et al: Invasive mucinous carcinoma of the breast and response patterns after neoadjuvant chemotherapy (NAC). Histopathology. 72(6):965-973, 2018
                                              4. Brogi E: Mucinous carcinoma. In Hoda SA et al: Rosen's Breast Pathology by Needle Core Biopsy. 4th ed. Philadelphia: Wolters Kluwer. 259-274, 2017
                                              5. Guo Y et al: Whole-lesion histogram analysis of the apparent diffusion coefficient: Evaluation of the correlation with subtypes of mucinous breast carcinoma. J Magn Reson Imaging. ePub, 2017
                                              6. Shin YG et al: Magnetic resonance imaging and pathological characteristics of pure mucinous carcinoma in the breast according to echogenicity on ultrasonography. Ultrasonography. 36(2):131-138, 2017
                                              7. Bitencourt AG et al: MRI features of mucinous cancer of the breast: Correlation with pathologic findings and other imaging methods. AJR Am J Roentgenol. 206(2):238-46, 2016
                                              8. Dong A et al: Spectrum of the breast lesions with increased 18F-FDG uptake on PET/CT. Clin Nucl Med. 41(7):543-57, 2016
                                              9. Ferré R et al: Differentiation of fibroadenomas and pure mucinous carcinomas on dynamic contrast-enhanced MRI of the breast using volume segmentation for kinetic analysis: a feasibility study. AJR Am J Roentgenol. 206(2):253-8, 2016
                                              10. Fu J et al: Clinical nomogram for predicting survival outcomes in early mucinous breast cancer. PLoS One. 11(10):e0164921, 2016
                                              11. Igarashi T et al: Use of BI-RADS-MRI descriptors for differentiation between mucinous carcinoma and fibroadenoma. Eur J Radiol. 85(6):1092-8, 2016
                                              12. Karan B et al: Diffusion-weighted imaging and (18) F-fluorodeoxyglucose positron emission tomography/computed tomography in breast cancer: correlation of the apparent diffusion coefficient and maximum standardized uptake values with prognostic factors. J Magn Reson Imaging. 43(6):1434-44, 2016
                                              13. Nassar L et al: Predictors of malignancy in hyperechoic breast lesions. J Ultrasound Med. 35(4):783-90, 2016
                                              14. Nam SY et al: Ultrasonographic hyperechoic lesions of the breast: are they always benign? Acta Radiol. 56(1):18-24, 2015
                                              15. Nardello SM et al: Invasive mucinous carcinoma arising in ectopic axillary breast tissue: a case report and literature review. Am J Case Rep. 16:153-9, 2015
                                              16. Onishi N et al: Apparent diffusion coefficient as a potential surrogate marker for Ki-67 index in mucinous breast carcinoma. J Magn Reson Imaging. 41(3):610-5, 2015
                                              17. Zhang L et al: Comparative analysis of imaging and pathology features of mucinous carcinoma of the breast. Clin Breast Cancer. 15(2):e147-54, 2015
                                              18. Grajo JR et al: Strain elastography for prediction of breast cancer tumor grades. J Ultrasound Med. 33(1):129-34, 2014
                                              19. Westra C et al: Using T2-weighted sequences to more accurately characterize breast masses seen on MRI. AJR Am J Roentgenol. 202(3):W183-90, 2014
                                              20. Corben AD et al: Mucinous carcinoma. In Hoda SA et al: Rosen's Breast Pathology. 4th ed. Philadelphia: Lippincott Williams & Wilkins, 2014
                                              21. Barbashina V et al: Mucinous micropapillary carcinoma of the breast: an aggressive counterpart to conventional pure mucinous tumors. Hum Pathol. 44(8):1577-85, 2013
                                              22. Farrokh A et al: Evaluation of real-time tissue sono-elastography in the assessment of 214 breast lesions: limitations of this method resulting from different histologic subtypes, tumor size and tumor localization. Ultrasound Med Biol. 39(12):2264-71, 2013
                                              23. Kaoku S et al: Sonographic and pathologic image analysis of pure mucinous carcinoma of the breast. Ultrasound Med Biol. 39(7):1158-67, 2013
                                              24. Kryvenko ON et al: Precursor lesions of mucinous carcinoma of the breast: analysis of 130 cases. Am J Surg Pathol. 37(7):1076-84, 2013
                                              25. Tan JZ et al: Mucinous carcinomas of the breast: imaging features and potential for misdiagnosis. J Med Imaging Radiat Oncol. 57(1):25-31, 2013
                                              26. Cao AY et al: Outcome of pure mucinous breast carcinoma compared to infiltrating ductal carcinoma: a population-based study from China. Ann Surg Oncol. 19(9):3019-27, 2012
                                              27. Karan B et al: Unusual malignant breast lesions: imaging-pathological correlations. Diagn Interv Radiol. 18(3):270-6, 2012
                                              28. Le-Petross H et al: Challenges and potential pitfalls in magnetic resonance imaging of more elusive breast carcinomas. Semin Ultrasound CT MR. 32(4):342-50, 2011
                                              29. Linda A et al: Unusual malignant tumors of the breast: MRI features and pathologic correlation. Eur J Radiol. 75(2):178-84, 2010
                                              30. Santamaria G et al: Radiologic and pathologic findings in breast tumors with high signal intensity on T2-weighted MR images. Radiographics. 30:533-48, 2010
                                              31. Yoo JL et al: Can MR Imaging contribute in characterizing well-circumscribed breast carcinomas? Radiographics. 30(6):1689-702, 2010
                                              32. Begum SM et al: Mucin extravasation in breast core biopsies--clinical significance and outcome correlation. Histopathology. 55(5):609-17, 2009
                                              33. Chang YW et al: Synchronous bilateral mucinous carcinoma of the breast: case report. Clin Imaging. 33(1):62-6, 2009
                                              34. Woodhams R et al: Diffusion-weighted imaging of mucinous carcinoma of the breast: evaluation of apparent diffusion coefficient and signal intensity in correlation with histologic findings. AJR Am J Roentgenol. 193(1):260-6, 2009
                                              35. Di Saverio S et al: A retrospective review with long term follow up of 11,400 cases of pure mucinous breast carcinoma. Breast Cancer Res Treat. 111(3):541-7, 2008
                                              36. Jinguji M et al: Rim enhancement of breast cancers on contrast-enhanced MR imaging: relationship with prognostic factors. Breast Cancer. 13(1):64-73, 2006
                                              37. Lam WW et al: Role of fine needle aspiration and tru cut biopsy in diagnosis of mucinous carcinoma of breast--from a radiologist's perspective. Clin Imaging. 30(1):6-10, 2006
                                              38. Narisada H et al: Correlation between numeric gadolinium-enhanced dynamic MRI ratios and prognostic factors and histologic type of breast carcinoma. AJR Am J Roentgenol. 187(2):297-306, 2006
                                              39. Farshid G et al: Mucocele-like lesions of the breast: a benign cause for indeterminate or suspicious mammographic microcalcifications. Breast J. 11(1):15-22, 2005
                                              40. Mizuta Y et al: A case of non-metastatic giant mucinous carcinoma of the breast. Breast Cancer. 12(4):337-40, 2005
                                              41. Rakha EA et al: Expression of mucins (MUC1, MUC2, MUC3, MUC4, MUC5AC and MUC6) and their prognostic significance in human breast cancer. Mod Pathol. 18(10):1295-304, 2005
                                              42. Bassett L et al: Diagnosis of Diseases of the Breast. 2nd ed. Philadelphia: Elsevier Saunders. 504-6, 2004
                                              43. Harris J et al: Diseases of the Breast. 3rd ed. Philadelphia: Lippincott Williams & Wilkins. 549-41, 2004
                                              44. Komenaka IK et al: Pure mucinous carcinoma of the breast. Am J Surg. 187(4):528-32, 2004
                                              45. Lam WW et al: Sonographic appearance of mucinous carcinoma of the breast. AJR Am J Roentgenol. 182(4):1069-74, 2004
                                              46. Stavros AT: Breast Ultrasound. Philadelphia: Lippincott Williams & Wilkins. 645-8, 2004
                                              47. Gupta RK et al: Needle aspiration cytodiagnosis of mucinous (colloid) carcinoma of male breast. Pathology. 35(6):539-40, 2003
                                              48. Kawashima M et al: MR imaging of mucinous carcinoma of the breast. AJR Am J Roentgenol. 179(1):179-83, 2002
                                              49. Rosen P: Rosen's Breast Pathology. 2nd ed. Philadelphia: Lippincott Williams & Wilkins. 463-81, 2001
                                              50. Matsuda M et al: Mammographic and clinicopathological features of mucinous carcinoma of the breast. Breast Cancer. 7(1):65-70, 2000
                                              51. Memis A et al: Mucinous (colloid) breast cancer: mammographic and US features with histologic correlation. Eur J Radiol. 35(1):39-43, 2000
                                              52. Fujikawa T et al: A case of mucinous carcinoma of the male breast with unusual ultrasonographic findings mimicking phyllodes tumor. Breast Cancer. 5(1):83-86, 1998
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        TERMINOLOGY

                                                        • Synonyms

                                                          • Mucinous carcinoma = colloid, gelatinous, or mucous carcinoma
                                                        • Definitions

                                                          • Uncommon subtype of invasive ductal carcinoma (IDC) characterized by large amounts of extracellular mucin
                                                            • Pure type: ≥ 90% of tumor shows mucin production
                                                            • Mixed type: Tumors with less extensive mucin = IDC with mucinous features

                                                        IMAGING

                                                        • General Features

                                                          • Mammographic Findings

                                                            • Ultrasonographic Findings

                                                              • Image-Guided Biopsy

                                                                • MR Findings

                                                                  • Nuclear Medicine Findings

                                                                    • Imaging Recommendations

                                                                      DIFFERENTIAL DIAGNOSIS

                                                                        PATHOLOGY

                                                                        • General Features

                                                                          • Gross Pathologic & Surgical Features

                                                                            • Microscopic Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Chaudhry AR et al: Imaging features of pure and mixed forms of mucinous breast carcinoma with histopathological correlation. Br J Radiol. 20180810, 2019
                                                                                          2. Pareja F et al: The Genomic Landscape of Mucinous Breast Cancer. J Natl Cancer Inst. ePub, 2019
                                                                                          3. Didonato R et al: Invasive mucinous carcinoma of the breast and response patterns after neoadjuvant chemotherapy (NAC). Histopathology. 72(6):965-973, 2018
                                                                                          4. Brogi E: Mucinous carcinoma. In Hoda SA et al: Rosen's Breast Pathology by Needle Core Biopsy. 4th ed. Philadelphia: Wolters Kluwer. 259-274, 2017
                                                                                          5. Guo Y et al: Whole-lesion histogram analysis of the apparent diffusion coefficient: Evaluation of the correlation with subtypes of mucinous breast carcinoma. J Magn Reson Imaging. ePub, 2017
                                                                                          6. Shin YG et al: Magnetic resonance imaging and pathological characteristics of pure mucinous carcinoma in the breast according to echogenicity on ultrasonography. Ultrasonography. 36(2):131-138, 2017
                                                                                          7. Bitencourt AG et al: MRI features of mucinous cancer of the breast: Correlation with pathologic findings and other imaging methods. AJR Am J Roentgenol. 206(2):238-46, 2016
                                                                                          8. Dong A et al: Spectrum of the breast lesions with increased 18F-FDG uptake on PET/CT. Clin Nucl Med. 41(7):543-57, 2016
                                                                                          9. Ferré R et al: Differentiation of fibroadenomas and pure mucinous carcinomas on dynamic contrast-enhanced MRI of the breast using volume segmentation for kinetic analysis: a feasibility study. AJR Am J Roentgenol. 206(2):253-8, 2016
                                                                                          10. Fu J et al: Clinical nomogram for predicting survival outcomes in early mucinous breast cancer. PLoS One. 11(10):e0164921, 2016
                                                                                          11. Igarashi T et al: Use of BI-RADS-MRI descriptors for differentiation between mucinous carcinoma and fibroadenoma. Eur J Radiol. 85(6):1092-8, 2016
                                                                                          12. Karan B et al: Diffusion-weighted imaging and (18) F-fluorodeoxyglucose positron emission tomography/computed tomography in breast cancer: correlation of the apparent diffusion coefficient and maximum standardized uptake values with prognostic factors. J Magn Reson Imaging. 43(6):1434-44, 2016
                                                                                          13. Nassar L et al: Predictors of malignancy in hyperechoic breast lesions. J Ultrasound Med. 35(4):783-90, 2016
                                                                                          14. Nam SY et al: Ultrasonographic hyperechoic lesions of the breast: are they always benign? Acta Radiol. 56(1):18-24, 2015
                                                                                          15. Nardello SM et al: Invasive mucinous carcinoma arising in ectopic axillary breast tissue: a case report and literature review. Am J Case Rep. 16:153-9, 2015
                                                                                          16. Onishi N et al: Apparent diffusion coefficient as a potential surrogate marker for Ki-67 index in mucinous breast carcinoma. J Magn Reson Imaging. 41(3):610-5, 2015
                                                                                          17. Zhang L et al: Comparative analysis of imaging and pathology features of mucinous carcinoma of the breast. Clin Breast Cancer. 15(2):e147-54, 2015
                                                                                          18. Grajo JR et al: Strain elastography for prediction of breast cancer tumor grades. J Ultrasound Med. 33(1):129-34, 2014
                                                                                          19. Westra C et al: Using T2-weighted sequences to more accurately characterize breast masses seen on MRI. AJR Am J Roentgenol. 202(3):W183-90, 2014
                                                                                          20. Corben AD et al: Mucinous carcinoma. In Hoda SA et al: Rosen's Breast Pathology. 4th ed. Philadelphia: Lippincott Williams & Wilkins, 2014
                                                                                          21. Barbashina V et al: Mucinous micropapillary carcinoma of the breast: an aggressive counterpart to conventional pure mucinous tumors. Hum Pathol. 44(8):1577-85, 2013
                                                                                          22. Farrokh A et al: Evaluation of real-time tissue sono-elastography in the assessment of 214 breast lesions: limitations of this method resulting from different histologic subtypes, tumor size and tumor localization. Ultrasound Med Biol. 39(12):2264-71, 2013
                                                                                          23. Kaoku S et al: Sonographic and pathologic image analysis of pure mucinous carcinoma of the breast. Ultrasound Med Biol. 39(7):1158-67, 2013
                                                                                          24. Kryvenko ON et al: Precursor lesions of mucinous carcinoma of the breast: analysis of 130 cases. Am J Surg Pathol. 37(7):1076-84, 2013
                                                                                          25. Tan JZ et al: Mucinous carcinomas of the breast: imaging features and potential for misdiagnosis. J Med Imaging Radiat Oncol. 57(1):25-31, 2013
                                                                                          26. Cao AY et al: Outcome of pure mucinous breast carcinoma compared to infiltrating ductal carcinoma: a population-based study from China. Ann Surg Oncol. 19(9):3019-27, 2012
                                                                                          27. Karan B et al: Unusual malignant breast lesions: imaging-pathological correlations. Diagn Interv Radiol. 18(3):270-6, 2012
                                                                                          28. Le-Petross H et al: Challenges and potential pitfalls in magnetic resonance imaging of more elusive breast carcinomas. Semin Ultrasound CT MR. 32(4):342-50, 2011
                                                                                          29. Linda A et al: Unusual malignant tumors of the breast: MRI features and pathologic correlation. Eur J Radiol. 75(2):178-84, 2010
                                                                                          30. Santamaria G et al: Radiologic and pathologic findings in breast tumors with high signal intensity on T2-weighted MR images. Radiographics. 30:533-48, 2010
                                                                                          31. Yoo JL et al: Can MR Imaging contribute in characterizing well-circumscribed breast carcinomas? Radiographics. 30(6):1689-702, 2010
                                                                                          32. Begum SM et al: Mucin extravasation in breast core biopsies--clinical significance and outcome correlation. Histopathology. 55(5):609-17, 2009
                                                                                          33. Chang YW et al: Synchronous bilateral mucinous carcinoma of the breast: case report. Clin Imaging. 33(1):62-6, 2009
                                                                                          34. Woodhams R et al: Diffusion-weighted imaging of mucinous carcinoma of the breast: evaluation of apparent diffusion coefficient and signal intensity in correlation with histologic findings. AJR Am J Roentgenol. 193(1):260-6, 2009
                                                                                          35. Di Saverio S et al: A retrospective review with long term follow up of 11,400 cases of pure mucinous breast carcinoma. Breast Cancer Res Treat. 111(3):541-7, 2008
                                                                                          36. Jinguji M et al: Rim enhancement of breast cancers on contrast-enhanced MR imaging: relationship with prognostic factors. Breast Cancer. 13(1):64-73, 2006
                                                                                          37. Lam WW et al: Role of fine needle aspiration and tru cut biopsy in diagnosis of mucinous carcinoma of breast--from a radiologist's perspective. Clin Imaging. 30(1):6-10, 2006
                                                                                          38. Narisada H et al: Correlation between numeric gadolinium-enhanced dynamic MRI ratios and prognostic factors and histologic type of breast carcinoma. AJR Am J Roentgenol. 187(2):297-306, 2006
                                                                                          39. Farshid G et al: Mucocele-like lesions of the breast: a benign cause for indeterminate or suspicious mammographic microcalcifications. Breast J. 11(1):15-22, 2005
                                                                                          40. Mizuta Y et al: A case of non-metastatic giant mucinous carcinoma of the breast. Breast Cancer. 12(4):337-40, 2005
                                                                                          41. Rakha EA et al: Expression of mucins (MUC1, MUC2, MUC3, MUC4, MUC5AC and MUC6) and their prognostic significance in human breast cancer. Mod Pathol. 18(10):1295-304, 2005
                                                                                          42. Bassett L et al: Diagnosis of Diseases of the Breast. 2nd ed. Philadelphia: Elsevier Saunders. 504-6, 2004
                                                                                          43. Harris J et al: Diseases of the Breast. 3rd ed. Philadelphia: Lippincott Williams & Wilkins. 549-41, 2004
                                                                                          44. Komenaka IK et al: Pure mucinous carcinoma of the breast. Am J Surg. 187(4):528-32, 2004
                                                                                          45. Lam WW et al: Sonographic appearance of mucinous carcinoma of the breast. AJR Am J Roentgenol. 182(4):1069-74, 2004
                                                                                          46. Stavros AT: Breast Ultrasound. Philadelphia: Lippincott Williams & Wilkins. 645-8, 2004
                                                                                          47. Gupta RK et al: Needle aspiration cytodiagnosis of mucinous (colloid) carcinoma of male breast. Pathology. 35(6):539-40, 2003
                                                                                          48. Kawashima M et al: MR imaging of mucinous carcinoma of the breast. AJR Am J Roentgenol. 179(1):179-83, 2002
                                                                                          49. Rosen P: Rosen's Breast Pathology. 2nd ed. Philadelphia: Lippincott Williams & Wilkins. 463-81, 2001
                                                                                          50. Matsuda M et al: Mammographic and clinicopathological features of mucinous carcinoma of the breast. Breast Cancer. 7(1):65-70, 2000
                                                                                          51. Memis A et al: Mucinous (colloid) breast cancer: mammographic and US features with histologic correlation. Eur J Radiol. 35(1):39-43, 2000
                                                                                          52. Fujikawa T et al: A case of mucinous carcinoma of the male breast with unusual ultrasonographic findings mimicking phyllodes tumor. Breast Cancer. 5(1):83-86, 1998