伴有黏液的乳腺病变包括了一组从良性到恶性的上皮性病变，如黏液囊肿样病变、黏液癌、实性乳头状癌及黏液性囊腺癌等。本文对常见乳腺黏液性病变，特别是肿瘤性病变的病理诊断及鉴别诊断要点进行梳理，包括与黏液癌易混淆的特殊类型非粘液或转移性癌的鉴别诊断要点。笔者特别注意到单纯型黏液癌中一种特殊表型——微乳头状型黏液癌，该亚型具有更具侵袭性的生物学行为，并建议对患者采取更积极的临床管理。对于乳腺黏液性病变谱系的正确认识和整体把握是实现临床精准治疗的基础。

Mucinous lesions of the breast include a group of epithelial lesions ranging from benign to malignant, such as mucocele-like lesion, mucinous carcinoma, solid papillary carcinoma and mucinous cystadenocarcinoma. The authors summarize the key points of pathological diagnosis and differential diagnosis of common breast mucinous lesions, especially neoplastic lesions, including several special types of non-mucinous or metastatic cancers that are easily confused with mucinous carcinomas. Attention is paid to a more aggressive phenotype of pure type mucinous carcinoma, micropapillary mucinous carcinoma, which presents more aggressive biological behaviors and suggests more aggressive clinical management. A correct understanding and overall grasp of the spectrum of breast mucinous lesions is the basis of precise clinical treatment.