Focal extravasated mucin in breast core needle biopsies: Is surgical excision always necessary? Journal Article


Authors: Edelweiss, M.; Corben, A. D.; Liberman, L.; Kaplan, J.; Nehhozina, T.; Catalano, J. P.; Brogi, E.
Article Title: Focal extravasated mucin in breast core needle biopsies: Is surgical excision always necessary?
Abstract: Focal extravasated mucin (EM) with benign or atypical epithelium is a rare finding at breast core needle biopsy (CNB) and usually prompts surgical excision to rule out mucin-producing carcinoma. In the largest detailed series to date, we assessed surgical outcomes in lesions yielding EM with atypical or nonatypical epithelium at CNB. With IRB approval, we retrospectively reviewed 28 consecutive atypical and nonatypical CNBs with EM that underwent surgical excision at our center over a 22-year period. CNB imaging and pathologic findings were concordant if pathology sufficiently explained the radiologic features of the lesions. Pathologic findings in CNB and excision specimens were correlated. Statistical analysis was performed. CNBs sampled mammographic calcifications in 25/28 (89%) women and a mass in 3/28 (11%). All cases had concordant pathologic and imaging findings. At CNB, the epithelium associated with EM was atypical in 18/28 (64%) lesions and nonatypical in 10 (36%). Cancer (one mucinous carcinoma; three ductal carcinoma in situ) was present in 4/28 excision specimens (14%; 95% confidence intervals [CI], 4%-33%). All carcinomas were in lesions with epithelial atypia at CNB (4/18; 22%; 95% CI, 6%-48%) versus none (0/10; 0%; 95% CI, 0%-31%) in nonatypical lesions at CNB; this difference was not statistically significant (p = 0.3). Surgery is warranted for lesions yielding EM with atypia at CNB due to the high (22%) prevalence of cancer. Our data suggest that surgical excision of lesions yielding EM without epithelial atypia at CNB may not be necessary provided that imaging and pathologic findings are concordant. © 2013 Wiley Periodicals, Inc.
Keywords: adult; clinical article; human tissue; aged; middle aged; retrospective studies; clinical feature; review; outcome assessment; follow-up studies; breast cancer; breast; mastectomy; prevalence; retrospective study; mammography; breast carcinoma; colloid carcinoma; breast biopsy; mucinous carcinoma; ultrasonography, interventional; mucin; mucins; atypical lobular hyperplasia; atypical ductal hyperplasia; biopsy, large-core needle; apocrine atypia; large core needle biopsy
Journal Title: Breast Journal
Volume: 19
Issue: 3
ISSN: 1075-122X
Publisher: Wiley Blackwell  
Date Published: 2013-05-01
Start Page: 302
End Page: 309
Language: English
DOI: 10.1111/tbj.12104
PROVIDER: scopus
PUBMED: 23534893
DOI/URL:
Notes: --- - "Export Date: 3 June 2013" - "CODEN: BRJOF" - "Source: Scopus"
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MSK Authors
  1. Jennifer Kaplan
    27 Kaplan
  2. Adriana Dionigi Corben
    66 Corben
  3. Laura Liberman
    176 Liberman
  4. Marcia Edelweiss
    105 Edelweiss
  5. Edi Brogi
    519 Brogi