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Mucinous breast lesions: diagnostic challenges

¹ Department of Pathology, Singapore General Hospital, Singapore
² Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
³ Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
⁴ Department of Anatomical and Cellular Pathology, Chinese University of Hong Kong, Hong Kong, PR China

Correspondence to:
Dr Puay Hoon Tan, Department of Pathology, Singapore General Hospital, Outram Road, Singapore 169608; tan.puay.hoon{at}singhealth.com.sg

ABSTRACT
Breast lesions with mucin represent a broad spectrum of entities, ranging from benign fibrocystic changes with luminal mucin to mucocele-like lesions (MLL), which can be associated with banal epithelial alterations, atypical ductal hyperplasia or ductal carcinoma in situ. Occasionally invasive mucinous carcinoma can be identified in contiguity with MLL. Diagnostic challenges are enumerated, histological differentials are discussed, and a practical approach towards resolving some of these issues is provided. In addition to these lesions with abundant extracellular mucin, there are also conditions that feature stromal mucinous or myxoid material, as well as rare entities that demonstrate both epithelial extracellular and stromal mucin.