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Benign mucocele-like lesions of the breast: revisited.
Mod Pathol. 2011 May; 24(5):683-7.MP

Abstract

Mucocele-like lesions of the breast are ruptured ducts that discharge their contents into the stroma. They constitute a spectrum from benign to atypical to malignant. The current management of these lesions diagnosed on core biopsy is excision. The goal of our study was to evaluate the necessity of this practice for benign mucocele-like lesions. Retrospective review of the pathology database from 1 January 2000 to 1 June 2008 identified 61 cases, with follow-up information available in 50 cases. Clinical, radiological, and pathological information was correlated. Core biopsies were reviewed to confirm the diagnosis and verify previous biopsy site. In all, 45 patients underwent surgery, whereas 5 patients were followed for >1 year and remained stable. Patient's ages ranged from 44 to 76 years. Most benign mucoceles were diagnosed stereotactically while targeting calcifications (93.3%); rarely, the lesion was a sonographically detected mass. Most excisions had no residual mucocele (37/45=82%). In seven cases (15.6%), atypical duct hyperplasia was present, three with residual mucocele. In one case, the residual mucocele showed a continuum from florid to atypical duct hyperplasia at the core biopsy site. The other six cases showed atypical duct hyperplasia adjacent to but not directly at the core biopsy site. The sizes of the benign mucoceles ranged from incipient to 0.6 cm, all containing calcifications except one, which was incidental. Radiological-pathological correlation was concordant in all cases except one with suspicious calcification, which was ductal carcinoma in situ on excision. In this series, the largest of its kind, the upstage rate of benign mucoceles diagnosed on core biopsy was 17.8%. With the exception of the ductal carcinoma in situ case, no radiological or morphological features were predictive of atypia. Thus, because of associated atypical duct hyperplasia, sampling reasons, and intralesional heterogeneity, we continue to recommend excision of benign mucocele-like lesions diagnosed on core biopsy.

Authors+Show Affiliations

Department of Pathology, The Mount Sinai Medical Center, New York, NY 10029, USA. Shabnam.Jaffer@msnyuhealth.orgNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21240257

Citation

Jaffer, Shabnam, et al. "Benign Mucocele-like Lesions of the Breast: Revisited." Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc, vol. 24, no. 5, 2011, pp. 683-7.
Jaffer S, Bleiweiss IJ, Nagi CS. Benign mucocele-like lesions of the breast: revisited. Mod Pathol. 2011;24(5):683-7.
Jaffer, S., Bleiweiss, I. J., & Nagi, C. S. (2011). Benign mucocele-like lesions of the breast: revisited. Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc, 24(5), 683-7. https://doi.org/10.1038/modpathol.2010.235
Jaffer S, Bleiweiss IJ, Nagi CS. Benign Mucocele-like Lesions of the Breast: Revisited. Mod Pathol. 2011;24(5):683-7. PubMed PMID: 21240257.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Benign mucocele-like lesions of the breast: revisited. AU - Jaffer,Shabnam, AU - Bleiweiss,Ira J, AU - Nagi,Chandandeep S, Y1 - 2011/01/14/ PY - 2011/1/18/entrez PY - 2011/1/18/pubmed PY - 2011/8/19/medline SP - 683 EP - 7 JF - Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc JO - Mod Pathol VL - 24 IS - 5 N2 - Mucocele-like lesions of the breast are ruptured ducts that discharge their contents into the stroma. They constitute a spectrum from benign to atypical to malignant. The current management of these lesions diagnosed on core biopsy is excision. The goal of our study was to evaluate the necessity of this practice for benign mucocele-like lesions. Retrospective review of the pathology database from 1 January 2000 to 1 June 2008 identified 61 cases, with follow-up information available in 50 cases. Clinical, radiological, and pathological information was correlated. Core biopsies were reviewed to confirm the diagnosis and verify previous biopsy site. In all, 45 patients underwent surgery, whereas 5 patients were followed for >1 year and remained stable. Patient's ages ranged from 44 to 76 years. Most benign mucoceles were diagnosed stereotactically while targeting calcifications (93.3%); rarely, the lesion was a sonographically detected mass. Most excisions had no residual mucocele (37/45=82%). In seven cases (15.6%), atypical duct hyperplasia was present, three with residual mucocele. In one case, the residual mucocele showed a continuum from florid to atypical duct hyperplasia at the core biopsy site. The other six cases showed atypical duct hyperplasia adjacent to but not directly at the core biopsy site. The sizes of the benign mucoceles ranged from incipient to 0.6 cm, all containing calcifications except one, which was incidental. Radiological-pathological correlation was concordant in all cases except one with suspicious calcification, which was ductal carcinoma in situ on excision. In this series, the largest of its kind, the upstage rate of benign mucoceles diagnosed on core biopsy was 17.8%. With the exception of the ductal carcinoma in situ case, no radiological or morphological features were predictive of atypia. Thus, because of associated atypical duct hyperplasia, sampling reasons, and intralesional heterogeneity, we continue to recommend excision of benign mucocele-like lesions diagnosed on core biopsy. SN - 1530-0285 UR - https://www.unboundmedicine.com/medline/citation/21240257/Benign_mucocele_like_lesions_of_the_breast:_revisited_ L2 - https://doi.org/10.1038/modpathol.2010.235 DB - PRIME DP - Unbound Medicine ER -