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Updated: Sep 3, 2026
Clinical Imaging of Microwave Mammography
Published on: November 14, 2025
Differentiating Pure and Mixed Mucinous Breast Carcinoma Using Multimodality Imaging: A Retrospective Single-Center
Gülnur Erdem1, Mahmut Bilal Dogan2, Mizgin Yamer1
1İstanbul Medeniyet University Faculty of Medicine, Department of Radiology, İstanbul, Türkiye.
Objective:
This study aimed to evaluate the efficacy of mammography, ultrasound, and magnetic resonance imaging (MRI) features in differentiating pure from mixed mucinous breast carcinoma and in identifying imaging characteristics specific to each subtype.
Methods:
This retrospective single-center study included 68 patients diagnosed with mucinous breast carcinoma between 2017 and 2024. The tumors were classified as pure or mixed mucinous breast carcinomas based on histopathological findings. All available mammography, ultrasound, and MRI examinations were evaluated by a radiologist blinded to the histopathological subtypes. The features, such as tumor shape, margin, signal intensity, mammographic density, echogenicity, and calcifications, were assessed to identify distinctive patterns associated with pure and mixed mucinous breast tumors.
Results:
Among the 68 patients, 31 (45.6%) had pure mucinous tumors, while 37 (54.4%) had mixed tumors. On ultrasound, pure mucinous carcinomas more frequently demonstrated an oval shape and a homogeneous internal echo pattern, whereas mixed tumors more frequently exhibited an irregular shape (p<0.05). Mammography showed that non-circumscribed margins were significantly more common in mixed tumors than in pure tumors (p=0.02). On MRI, pure mucinous carcinomas predominantly exhibited oval or lobulated shapes, whereas mixed tumors more frequently exhibited irregular shapes (p=0.02). Pure tumors also showed higher T2 signal intensity (p=0.02) and significantly higher median apparent diffusion coefficient (ADC) values than mixed tumors (1815 [interquartile range (IQR), 1596-2062.5] vs. 1336.5 [IQR, 904.25-1602.5]×10-6 mm²/s, p=0.01).
Conclusions:
A multimodal imaging approach facilitates differentiation between pure and mixed mucinous breast carcinomas. Among the evaluated modalities, MRI provided the greatest discriminatory value, particularly through T2 signal intensity and ADC measurements, and may complement core needle biopsy when tissue sampling is limited.
