Mucocelelike Lesions in the Breast: Radiologic and Clinicopathologic Correlations With Upgrade Rate

The purpose of this article is to investigate the radiologic and clinicopathologic findings of mucocelelike lesions (MLLs) and the rate of pathologic upgrade with factors predicting it.

We reviewed our institution's database from January 2006 to December 2012 and enrolled 89 women with 89 MLLs. The pathologic findings from the initial biopsies identified 71 lesions without and 18 lesions with associated high-risk lesions. Images were reviewed according to the BI-RADS lexicon. Clinical and pathologic results were analyzed statistically, and upgrade rates were calculated.

Of the 89 lesions, 67 (75.3%) underwent surgical excision and 22 (24.7%) did not. After surgical excision (n = 67), one lesion was upgraded to mucinous carcinoma, three were upgraded to ductal carcinoma in situ, and 16 were upgraded to MLLs with associated high-risk lesions (29.9% total upgrade rate; 20/67). A statistically significant higher percentage of MLLs with associated high-risk lesions was observed in the surgical excision group (94.4% vs 70.4%; p = 0.036). The final pathologic diagnosis revealed larger lesions (16.4 ± 9.1 vs 12.6 ± 6.8 mm; p = 0.024) and younger patients in the high-risk group (46.9 ± 7.7 vs 50.6 ± 9.1 years; p = 0.049). Although no significant differences were observed in the imaging findings, including the BI-RADS category, upgraded lesions were seen as a mass with calcification as a predominant feature.

This study revealed no significant differences in imaging findings or BI-RADS category between high-risk and non-high-risk breast MLLs. However, we confirmed that high-risk lesions typically are seen as larger masses with calcifications.