Colloid or Mucinous Carcinoma
Colloid Carcinoma, sometimes called ‘mucinous‘ or mucin-producing carcinoma, is a type of invasive ductal breast cancer. The distinguishing feature of colloid carcinoma is the production of mucous. At the cellular level mucinous carcinoma appears of ‘islands‘ of malignant cells within ‘lakes‘ of mucous. Tumors for this cancer type can grow very large, and are often softer to the touch. Statistically, mucinous breast cancer accounts for approximately 3% of all breast carcinoma. It is rare in younger women and tends to effect women in their 60s. For women 75 years or older, colloid breast cancer accounts for approximately 7% of all tumors.
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Mixed and Pure mucinous carcinoma
Although mucinous breast cancer is thought to be a low to medium grade, slow-growing carcinoma, it is believed that some variants of the disease are more aggressive than others. If histological evaluation reveals that mucinous elements are ‘mixed‘ in with the collections of malignant cells, rather than being completely expelled to the surrounding mucous lakes, the prognosis is somewhat less favorable. A “pure” mucinous carcinoma contains no mucous within the malignant elements, and this seems to be a more favorable disposition. The ‘mixed‘ presentation has been demonstrated to be more likely to metastasize to the lymph nodes. Other studies have shown that the presence of neuro-endocrine cells may be associated with this less-aggressive, ‘pure‘ carcinoma. There is also speculation that an ‘alternating pattern‘ of malignant cell orientation may lead to a slower tumor growth pattern, due to the ‘bonding‘ and containment benefits of the surrounding stroma.
Other considerations and treatment options.
Mucinous carcinoma tends to be highly estrogen-dependent, and HER2/neu negative. It also typically releases a sialic acid called ‘C9-O‘, which is quite easy to spot through histo-chemical analysis.
Mucinous breast carcinoma tends to feature palpable tumors. These tumors are often highly positive for estrogen receptors, but HER2/neu negative. Lymph node metastasis is actually somewhat rare, unless the tumor is ER negative. It has also been suggested that mucinous carcinoma of the breast is more aggressive with when diagnosed in younger women.
Axillary node metastasis is uncommon for smaller tumors
Axillary lymph node metastasis is rare for tumors less than 3cm in diameter, and ‘comedo‘ or ‘plugged-duct‘ growth patterns are infrequent, occurring in approximately 11% of cases. So for women with “pure” mucinous carcinoma, breast conserving therapies might be a reasonable option. Unless the tumor is larger than 5 cm or invading the local skin, non surgical treatments are quite reasonable.
The outlook for mucinous breast cancer is highly favorable
In terms of prognosis, mucinous carcinoma has a favorable outlook. Women with this diagnosis have demonstrated a 10 year survival rate of 90% or more. In most cases, mucinous carcinoma does not metastasize to the lymph nodes or to other parts of the body.
Here are some Q&A:
- What is mucinous carcinoma made up of? This type of cancer is a tumor made up of abnormal cell that float in pools of mucin, a key ingredient in the slimy, slippery substance known as mucus.
- What are the signs and symptoms of mucinous carcinoma? Like other types of breast cancer, mucinous breast carcinoma may not cause any symptoms at first. Over time, a lump may grow large enough to be felt during breast self-examination or examination by a doctor.
- How big is mucinous carcinoma? The average mucinous carcinoma is about 3 cm, although they can be either smaller or larger than that.
- How is mucinous carcinoma diagnosed? It involves a combination of steps. These include physical examination of the breasts, a mammogram, ultrasound, MRI, and biopsy. Now or after surgery, the tissue should be tested for some other important features of a pure mucinous breast carcinoma. These include hormone receptor positive status, and HER2 negative status.
- What is the treatment for mucinous carcinoma? You and your doctor will work together analyse ways to develop your treatment plan for mucinous carcinoma of the breast. Treatment plans may include surgery to remove the cancer and in some cases any affected lymph nodes (lumpectomy, total or simple mastectomy), and adjuvant therapy (radiation therapy, hormonal therapy, or chemotherapy)
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