Columnar cell mucinous carcinoma of the breast – (Mucinous Cystadenocarcinoma MCA)

A columnar cell mucinous breast carcinoma is a subtype of all mucinous breast tumors, which are characterized by an overabundance of extracellular and/or intracellular mucin. Columnar cell mucinous breast tumors are also frequently referred to as breast mucinous cystadenomacarcinomas. Columnar cell mucinous breast tumors are quite rare, but nonetheless are a clinicopathologically distinct form of primary breast cancer.

This page is getting somewhat old… well kind of. It is young enough to still use, but old enough to decide to create a newer version with more up-to-date information on Columnar Cell Mucinous Carcinoma of the Breast.

In order to be classified as a ‘mucinous‘ breast carcinoma, it is generally acknowledged that at least 50% of the malignant cells should be mucinous, or rather, suspended in mucin. When the malignant cells are suspended in ‘extra cellular‘ mucin, one tends to use the term ‘mucinous carcinoma‘, but when they are suspend in ‘intracellular mucin‘, one tends to describe the tumor as signet ring cell carcinoma.

So, a columnar call mucinous breast carcinoma (also called mucinous cystadenocarcoma) is a term which might be given to a tumor which shows malignant cells suspended both in extracellular and intracellular mucin.

There may often be large amounts of free extra-cellular mucin

The image below shows a columnar cell mucinous breast carcinoma in which there are large quantities of extra cellular free mucin.

In the image columnar cell mucinous breast carcinoma below, on the other hand, the malignant cells are largely suspended in the intracytoplasmic mucin within the tumor.

Histological features of columnar cell mucinous breast carcinomas are somewhat unique

On cytological evaluation, columnar cell mucinous breast carcinomas tend to be characterized by large cystic spaces lined by columnar mucinous cells in various formations. Microscopically, these tumors are also characterized by abundant extra cellular and intracellular mucin, and they appear much like a mucinous cystic neoplasm of the ovary or pancreas.

Most of these tumors tend to show negative reactivity for estrogen and progesterone receptors in most cells, but it is difficult to make broad generalizations. Many columnar cell mucinous breast tumors also will stain positively for cytokeratin 7 and Ki-67.

Columnar cell mucinous breast cancer tends to affect older women, but prognosis is generally very good

All of the mucinous breast carcinomas represent 1% to 4% of breast cancers, and as a group they tend to affect older women than other types of breast cancer. The average age of developing a columnar cell mucinous carcinoma of the breast is between 60 and 70 years of age. These tumors tend to grow to a large size, but are not prone to metastasis to the lymph nodes.

Overall survival rate about 80%

Columnar cell mucinous breast carcinomas tend to be treated with mastectomy. Lymph node dissection may not be necessary, as these tumors are not that prone to metastasis. Radiation therapy and chemical therapy may be beneficial on some cases. As such, the outlook and long term survival rates for columnar cell mucinous breast carcinoma is very good. The twenty year survival rate for women with columnar cell mucinous breast cancer can be estimated at over 80%.

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For further reading, I suggest you visit this page that has information on mucinous cystadenocarcinoma of the breast, as well as this page on mucinous carcinoma.

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References

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4. Di Saverio S, Gutierrez J, Avisar E. A retrospective review with long term follow up of 11,400 cases of pure mucinous breast carcinoma. Breast Cancer Res Treat 2008;111(3):541-547.
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6. Koenig, C., Tavassoli, F., American Journal of Surgical Pathology: June 1998 – Volume 22 – Issue 6 – pp 698-703
7. Toikkanen S, Kujari H. Pure and mixed mucinous carcinomas of the breast: a clinicopathologic analysis of 61 cases with long-term follow-up. Hum Pathol 1989; 20: 758–764.
8. Chen WY, Chen CS, Chen HC, Hung YJ, Chu JS: Mucinous cystadenocarcinoma of the breast coexisting with infiltrating ductal carcinoma. Pathology international 2004;54:781–786.
9. Coyne JD, Irion L: Mammary mucinous cystadenocarcinoma. Histopathology 2006;49:659–660.
10. Tan PH, Tse GM, Bay BH. Mucinous breast lesions: diagnostic challenges. J Clin Pathol. 2008 Jan;61(1):11-9.

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