Ultrasound Diagnosis And Clinicopathological Analysis Of Different Pathological Types Of Breast Mucinous Carcinoma

ObjectiveThrough retrospective analysis of the ultrasonographic and clinicopathologic features of mucinous breast carcinoma(MBC),to provide an individualized and scientific decision for its diagnosis and treatment.MethodsA retrospective random sampling of 37 breast mucinous carcinoma patients diagnosed and treated in the Department of Breast and Thyroid Surgery of Shandong Provincial Hospital from January 2016 to December 2017,and 50 breast invasive ductal carcinoma(IDC)patients and 30 breast fibroadenoma patients were selected as control subjects.The ultrasound imaging features of MBC and fibroadenoma patients were compared and analyzed,the clinicopathologic features and lymph node metastasis of different MBC types were analyzed,and the clinicopathologic features of MBC and IDC were compared.The treatment methods of different types of MBC were compared and analyzed,to make individualized and scientific treatment decisions.ResultsThe average age of MBC patients was over 55 years old,and the proportion of postmenopausal patients was more than 60%.The left breast was more common than the right breast,and the upper quadrant was more common.Compared with fibroadenomas,the ultrasound features of MBC masses were more often as follows:irregular shape,unclear border,internal micro calcification and swollen lymph nodes。When the ultrasonographic findings of the pure mucinous carcinoma were compared with those of the mixed mucinous carcinoma,the boundary of the latter was less clear.When compared an MBC group with an IDC,we found that there was no significant difference in tumor size and TNM staging between the two groups.C ompared with IDC,the pathological characteristic of MBC often showed less axillary lymph node metastasis,more hormone receptor positive,more HER-2 receptor negative,less high Ki-67 expression,and less P53 positive,and it was statistically significant(P<0.05).According to the recurrence risk grading,compared with IDC,MBC was mostly at low and medium recurrence risk,with statistical significance(P<0.05).Comparing the two types of MBC,we found that the proportion of TNM stage I or II was higher,and the proportion of hormone receptor positive,HER-2 negative and Ki-67 low expression accounted for a higher proportion,but there was no statistically significant difference between the two.Compared with pure mucinous breast carcinoma,mixed mucinous breast carcinoma was more likely to be accompanied by lymph node metastasis and had a higher risk of recurrence.To analyze the correlation between the clinicopathologic features of MBC and axillary lymph node metastasis,MBC with high Ki-67 expression and HER-2 positive was more prone to axillary lymph node metastasis.All MBC patients included in the study received surgery,chemotherapy,endocrinotherapy,radiotherapy and targeted therapy,while the proportion of pure type patients who received breast-conserving surgery and sentinel lymph node biopsy was higher(45.8%vs 7.7%),and it was statistically significant.Conclusion1.MBC patients were relatively older,more common in postmenopausal women,and more common in the left breast.2.Ultrasound images of MBC had certain characteristics,and it contributes to improving the diagnostic rate and decreasing the missed diagnosis for the examiner to improve the recognition of sonography.3.MBC was mostly characterized by high expression of hormone receptors,low expression of HER-2,Ki-67 and P53,and low axillary lymph node metastasis rate.According to the recurrence risk grading,MBC was mostly at low and medium recurrence risk.MBC with high expression of Ki-67 and HER-2 positive had a high rate of axillary lymph node metastasis.4.Compared with mixed mucinous breast carcinoma,pure mucinous breast carcinoma was more suitable for breast-conserving surgery and sentinel lymph node biopsy.