Invasive mucinous carcinoma of the breast and response patterns after neoadjuvant chemotherapy (NAC)

Rosemarie Didonato, Nella Shapiro, Tova C. Koenigsberg, Timothy D'Alfonso, Shabnam Jaffer, Susan A. Fineberg

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Aims: Neoadjuvant chemotherapy (NAC) is often used to treat localised invasive breast cancer. Invasive mucinous carcinoma (IMC) is considered to be an indolent form of invasive breast cancer, and is rarely treated with NAC. We report the largest series of IMCs treated with NAC, and report a characteristic, but not well recognised, pattern of pathological response. Methods and results: Our series included seven patients with IMC treated with NAC. Three patients presented with locally advanced disease, three patients had tumours that were HER-2/neu-positive, and four patients had tumours with admixed mucinous and micropapillary features. Clinical and imaging assessment of response showed persistent and, in some cases, progressive disease, despite evidence of significant pathological response in these cases. Pathological assessment after NAC demonstrated marked reduction in tumour cellularity, but persistent space-occupying mucin pools, showing acellular mucin in one case, <1% tumour cellularity in three cases, and 5-10% cellularity in three cases in both the treated breast and axillary lymph nodes. Conclusions: Persistent mass-forming low-cellular or acellular mucin pools can result in discordant clinical, imaging and pathological findings in IMC treated with NAC.

Original languageEnglish (US)
JournalHistopathology
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Mucinous Adenocarcinoma
Breast
Drug Therapy
Mucins
Neoplasms
Breast Neoplasms
Lymph Nodes

Keywords

  • Breast cancer
  • Invasive mucinous carcinoma
  • Neoadjuvant chemotherapy

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

Cite this

Didonato, R., Shapiro, N., Koenigsberg, T. C., D'Alfonso, T., Jaffer, S., & Fineberg, S. A. (Accepted/In press). Invasive mucinous carcinoma of the breast and response patterns after neoadjuvant chemotherapy (NAC). Histopathology. https://doi.org/10.1111/his.13451

Invasive mucinous carcinoma of the breast and response patterns after neoadjuvant chemotherapy (NAC). / Didonato, Rosemarie; Shapiro, Nella; Koenigsberg, Tova C.; D'Alfonso, Timothy; Jaffer, Shabnam; Fineberg, Susan A.

In: Histopathology, 01.01.2018.

Research output: Contribution to journalArticle

Didonato, Rosemarie ; Shapiro, Nella ; Koenigsberg, Tova C. ; D'Alfonso, Timothy ; Jaffer, Shabnam ; Fineberg, Susan A. / Invasive mucinous carcinoma of the breast and response patterns after neoadjuvant chemotherapy (NAC). In: Histopathology. 2018.
@article{36b177024c00453b8132e2c9e95261f7,
title = "Invasive mucinous carcinoma of the breast and response patterns after neoadjuvant chemotherapy (NAC)",
abstract = "Aims: Neoadjuvant chemotherapy (NAC) is often used to treat localised invasive breast cancer. Invasive mucinous carcinoma (IMC) is considered to be an indolent form of invasive breast cancer, and is rarely treated with NAC. We report the largest series of IMCs treated with NAC, and report a characteristic, but not well recognised, pattern of pathological response. Methods and results: Our series included seven patients with IMC treated with NAC. Three patients presented with locally advanced disease, three patients had tumours that were HER-2/neu-positive, and four patients had tumours with admixed mucinous and micropapillary features. Clinical and imaging assessment of response showed persistent and, in some cases, progressive disease, despite evidence of significant pathological response in these cases. Pathological assessment after NAC demonstrated marked reduction in tumour cellularity, but persistent space-occupying mucin pools, showing acellular mucin in one case, <1{\%} tumour cellularity in three cases, and 5-10{\%} cellularity in three cases in both the treated breast and axillary lymph nodes. Conclusions: Persistent mass-forming low-cellular or acellular mucin pools can result in discordant clinical, imaging and pathological findings in IMC treated with NAC.",
keywords = "Breast cancer, Invasive mucinous carcinoma, Neoadjuvant chemotherapy",
author = "Rosemarie Didonato and Nella Shapiro and Koenigsberg, {Tova C.} and Timothy D'Alfonso and Shabnam Jaffer and Fineberg, {Susan A.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1111/his.13451",
language = "English (US)",
journal = "Histopathology",
issn = "0309-0167",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - Invasive mucinous carcinoma of the breast and response patterns after neoadjuvant chemotherapy (NAC)

AU - Didonato, Rosemarie

AU - Shapiro, Nella

AU - Koenigsberg, Tova C.

AU - D'Alfonso, Timothy

AU - Jaffer, Shabnam

AU - Fineberg, Susan A.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Aims: Neoadjuvant chemotherapy (NAC) is often used to treat localised invasive breast cancer. Invasive mucinous carcinoma (IMC) is considered to be an indolent form of invasive breast cancer, and is rarely treated with NAC. We report the largest series of IMCs treated with NAC, and report a characteristic, but not well recognised, pattern of pathological response. Methods and results: Our series included seven patients with IMC treated with NAC. Three patients presented with locally advanced disease, three patients had tumours that were HER-2/neu-positive, and four patients had tumours with admixed mucinous and micropapillary features. Clinical and imaging assessment of response showed persistent and, in some cases, progressive disease, despite evidence of significant pathological response in these cases. Pathological assessment after NAC demonstrated marked reduction in tumour cellularity, but persistent space-occupying mucin pools, showing acellular mucin in one case, <1% tumour cellularity in three cases, and 5-10% cellularity in three cases in both the treated breast and axillary lymph nodes. Conclusions: Persistent mass-forming low-cellular or acellular mucin pools can result in discordant clinical, imaging and pathological findings in IMC treated with NAC.

AB - Aims: Neoadjuvant chemotherapy (NAC) is often used to treat localised invasive breast cancer. Invasive mucinous carcinoma (IMC) is considered to be an indolent form of invasive breast cancer, and is rarely treated with NAC. We report the largest series of IMCs treated with NAC, and report a characteristic, but not well recognised, pattern of pathological response. Methods and results: Our series included seven patients with IMC treated with NAC. Three patients presented with locally advanced disease, three patients had tumours that were HER-2/neu-positive, and four patients had tumours with admixed mucinous and micropapillary features. Clinical and imaging assessment of response showed persistent and, in some cases, progressive disease, despite evidence of significant pathological response in these cases. Pathological assessment after NAC demonstrated marked reduction in tumour cellularity, but persistent space-occupying mucin pools, showing acellular mucin in one case, <1% tumour cellularity in three cases, and 5-10% cellularity in three cases in both the treated breast and axillary lymph nodes. Conclusions: Persistent mass-forming low-cellular or acellular mucin pools can result in discordant clinical, imaging and pathological findings in IMC treated with NAC.

KW - Breast cancer

KW - Invasive mucinous carcinoma

KW - Neoadjuvant chemotherapy

UR - http://www.scopus.com/inward/record.url?scp=85042120815&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85042120815&partnerID=8YFLogxK

U2 - 10.1111/his.13451

DO - 10.1111/his.13451

M3 - Article

C2 - 29220097

AN - SCOPUS:85042120815

JO - Histopathology

JF - Histopathology

SN - 0309-0167

ER -