Analysis Of Clinicopathologic Features And Treatment Of 128 Mucinous Breast Adenocarcinoma Cases

Objectives:The aim of this study is to retrospectively analyze the clinicopathological features,diagnosis,treatment and survival of 128 patients with breast mucinous adenocarcinoma.Reviewing relative literature foreign to improve the acknowledge of MBC and provide optimal diagnosis and treatment methods for MBC patients.Methods:Review the clinical records of 128 patients of MBC from April 2006 and June 2016 in the Third Affiliated Hospital of Kunming Medical University.All the clinical records included the age of onset,first clinical signs and symptoms,menstruation(menarche age,whether menopause and menopause),reproductive history,breastfeeding history,B-ultrasound results of the first diagnosis(tumor size,mass location),lymph node metastasis and metastasis of postoperative,immunohistochemical results(expressions of ER,PR,Ki-67,Her-2),pathological types,diagnostic methods,related treatment conditions and so on.We regularly understand the patient's condition,survival,endocrine treatment and guide patients to rehabilitate and continue right treatment by outpatient reviews,telephone and other communication ways.Results:In this study,128 patients were all females with a mean age of 48.7.The size of the tumor was 0.9-10.2 cm and the average size was 3.1 cm in patients.The B-ultrasound was misdiagnosed as 36.7%.The follow-up time was 2-12 years and 6 patients died in all the patients.35 patients had lymph node metastases(27.2%),121 patients had ER(+)(94.6%),and 115 patients had PR(+)(89.2%).There were 117 patients of Her-2(-)(91.4%)and 76 cases(59.4%)of Ki-67<14%;The expression of ER,PR,Ki-67,Her-2 and tumor size have effect in the lymph nodes metastasis,and the difference has statistics significance(P<0.05).Univariate survival analysis revealed that axillary lymph node staging and tumor size had an impact on the overall survival of mucinous adenocarcinoma and the difference was statistically significant(P<0.05).There were 66 cases(51.56%)of PMBC(simple mucinous adenocarcinoma)and 62 cases(48.47%)of mixed mucinous adenocarcinoma.The onset age of patients with different pathological types,the time from the discovery of the mass to the visit,the menarche age and menstruation,the history of marriage,first clinical symptoms,misdiagnosis rate of B-ultrasound,size of tumor and location of tumor have no significant statistics difference(P>0.05).The lymph node metastasis(P=0.01),PR(P=0.04),Ki-67(P<0.0001)expression and overall survival have statistically significant(P=0.002).Conclusions:Mucinous breast adenocarcinoma is more common in middle-aged and old-aged women before or after menopause,of which unilateral single masses are more common and larger.The morphology of mucinous breast adenocarcinoma is similar to benign masses and the misdiagnosis rate of B-ultrasound is higher(especially in patients with PMBC).The prognosis of PMBC patients was better than that of MMBC patients,probably as PMBC patients had lower lymph node metastasis rate and lower PR,ki-67 expression than MMBC patients.ER,PR,Ki-67,Her-2 expression and tumor size were important factors in axillary lymph node metastasis,and the axillary lymph node metastasis and the number of metastasis affect the prognosis of MBC patients.Mucinous adenocarcinoma should not be treated with the common diagnosis and treatment models of breast cancer.Individualized treatment should be applied to patients with different pathological types of mucinous adenocarcinoma.