Zhou Wu, Li Yong-Zhong, Gao Li-Min, Cai Di-Ming
Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, China.
Department of Pathology, West China Hospital, Sichuan University, Chengdu, China.
Front Oncol. 2021 Oct 22;11:644180. doi: 10.3389/fonc.2021.644180. eCollection 2021.
Previous studies have mostly discussed the clinical manifestations and prognosis of mucinous breast carcinoma with a micropapillary pattern. The purposes of this study were to investigate the sonographic features of pure mucinous breast carcinoma with micropapillary pattern (MUMPC) and to identify the role of ultrasound in the differential diagnosis between MUMPC and conventional pure mucinous breast carcinoma (cPMBC).
We obtained written informed consent from all patients, and the Ethics Committee of West China Hospital approved this retrospective study. The study was conducted between May and August 2020. We enrolled 133 patients with 133 breast lesions confirmed as mucinous breast carcinoma (MBC) histopathologically between January 2014 and January 2020.We retrospectively assessed sonographic features (margin, shape, internal echogenicity, calcification, posterior acoustic feature, invasive growth, blood flow grade, and rate of missed diagnosis) and clinical characteristics (age, tumor size, tumor texture, initial symptom, and lymph node metastasis). Bivariable analyses were performed using SPSS version 19.0.
The 133 lesions included 11 MUMPCs, 65 cPMBCs, and 57 mixed MBCs (MMBCs). There were significant differences in margin, shape, calcification, posterior acoustic feature, invasive growth, rate of missed diagnosis, average tumor size, and lymph node metastasis among the three groups ( < 0.05). The subsequent pairwise comparisons showed that there were significant differences in lymph node metastasis, margin, and invasive growth between MUMPC and cPMBC ( < 0.05). In patients aged >45 years, there was a significant difference in tumor size among the three groups ( = 0.045), and paired comparison showed that the average tumor size in the cPMBC group was larger than that in the MMBC group ( = 0.014).
MUMPC showed a non-circumscribed margin and invasive growth more frequently than cPMBC did. Lymphatic metastasis was more likely to occur in MUMPC than cPMBC. Ultrasound is helpful to distinguish MUMPC from cPMBC.
既往研究大多讨论了具有微乳头结构的黏液性乳腺癌的临床表现和预后。本研究的目的是探讨纯微乳头型黏液性乳腺癌(MUMPC)的超声特征,并确定超声在MUMPC与传统纯黏液性乳腺癌(cPMBC)鉴别诊断中的作用。
我们获得了所有患者的书面知情同意,本回顾性研究经华西医院伦理委员会批准。研究于2020年5月至8月进行。我们纳入了2014年1月至2020年1月期间133例经组织病理学确诊为黏液性乳腺癌(MBC)的133例乳腺病变患者。我们回顾性评估了超声特征(边界、形态、内部回声、钙化、后方回声特征、浸润性生长、血流分级和漏诊率)以及临床特征(年龄、肿瘤大小、肿瘤质地、初始症状和淋巴结转移)。使用SPSS 19.0版进行双变量分析。
133个病变包括11例MUMPC、65例cPMBC和57例混合性MBC(MMBC)。三组在边界、形态、钙化、后方回声特征、浸润性生长、漏诊率、平均肿瘤大小和淋巴结转移方面存在显著差异(P<0.05)。随后的两两比较显示,MUMPC与cPMBC在淋巴结转移、边界和浸润性生长方面存在显著差异(P<0.05)。在年龄>45岁的患者中,三组在肿瘤大小方面存在显著差异(P = 0.045),配对比较显示cPMBC组的平均肿瘤大小大于MMBC组(P = 0.014)。
与cPMBC相比,MUMPC更常表现为边界不清和浸润性生长。MUMPC比cPMBC更容易发生淋巴转移。超声有助于区分MUMPC与cPMBC。