HistopathologyPub Date : 2025-08-18DOI: 10.1111/his.15534
Flora Mae Sta Ines, Amrik Eadara, M Ruhul Quddus, C James Sung, Kamaljeet Singh
{"title":"Re-appraisal of mucocele-like lesion of the breast with atypia: study of 34 cases with focus on impact of type and extent of atypia on upgrade.","authors":"Flora Mae Sta Ines, Amrik Eadara, M Ruhul Quddus, C James Sung, Kamaljeet Singh","doi":"10.1111/his.15534","DOIUrl":"https://doi.org/10.1111/his.15534","url":null,"abstract":"<p><strong>Aims: </strong>Mucocele-like lesions (MLL) of the breast are rare. MLL associated with flat epithelial atypia (FEA) or atypical ductal hyperplasia (ADH) is classified as MLL with atypia (AtypMLL). We study the upgrade rate and long-term outcomes in AtypMLL, focusing on the extent and type of atypia in needle biopsy (NB).</p><p><strong>Methods and results: </strong>AtypMLL in NB specimens from 1 January 2010 to 30 June 2023, were identified. Clinical data and histological findings in NB were recorded. Excision findings and long-term follow-up information were obtained. Statistical analysis was performed. Thirty-four NBs of AtypMLL, 5 (15%) with FEA and 29 (85%) with ADH were identified. Twenty-five out of 27 (93%) excisions revealed no upgrade; 9 were benign, and 16 showed residual ADH/FEA/lobular neoplasia. Two (7.4%) excisions upgraded to carcinoma: one low nuclear grade ductal carcinoma in situ (DCIS) and one histologic grade 2 invasive breast carcinoma, no special type. ADH was architecturally complex, and a significantly higher number of ADH foci were present in NB of two cases with the upgrade (5 and 7 foci, respectively). The ADH foci were significantly lower in the NB without the upgrade (1.79, 95% CI: 1.19, 2.39; P < 0.001 vs. upgrade). The foci of atypia in NBs increased progressively in excisions with benign, atypical and carcinoma findings. Two patients developed breast carcinoma at 6 and 16 months (median 73 months, 6-120 months).</p><p><strong>Conclusion: </strong>The upgrade rate of AtypMLL presenting with calcifications depends on the foci and architectural complexity of atypia in NB. The long-term outcome of AtypMLL appears favourable.</p>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144872916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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