Medullary breast carcinoma

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Medullary breast carcinoma
Diagnosis in short

LM all required: (1) lesion has well-circumscribed border, (2) syncytial growth pattern, (3) lymphocytic infiltrate, (4) high nuclear grade (as per Nottingham grading system), (5) no tubule formation
LM DDx Invasive ductal carcinoma with medullary features
IHC ER -ve, PR -ve, HER2 -ve
Grossing notes breast grossing
Staging breast cancer staging
Site breast - see invasive breast cancer

Prevalence uncommon
Prognosis better than NST

Medullary breast carcinoma is an uncommon form of invasive breast carcinoma.

It is also known as medullary carcinoma of the breast.

General

  • Uncommon breast cancer subtype.
  • Some pathologists very rarely make the diagnosis.[citation needed]

Epidemiology:

  • Thought to have a better prognosis that no special type (NST).
  • May be associated with a BRCA1 mutation.

Gross

  • Well-circumscribed border.[1]

Aside - malignant well-circumscribed breast masses - radiologic DDx:[1]

Microscopic

Features:

  1. Lesion has well-circumscribed border.
  2. Syncytial growth pattern = clumps of cells with poorly defined cell borders.
  3. Lymphocytic infiltrate.
  4. High nuclear grade (as per Nottingham grading system).
  5. No tubule formation.

DDx:

Images

IHC

Features - typical:[2]

  • ER -ve.
  • PR -ve.
  • HER2 -ve.

See also

References

  1. 1.0 1.1 Yoo, JL.; Woo, OH.; Kim, YK.; Cho, KR.; Yong, HS.; Seo, BK.; Kim, A.; Kang, EY. (Oct 2010). "Can MR Imaging contribute in characterizing well-circumscribed breast carcinomas?". Radiographics 30 (6): 1689-702. doi:10.1148/rg.306105511. PMID 21071383.
  2. Matkovic, B.; Juretic, A.; Separovic, V.; Novosel, I.; Separovic, R.; Gamulin, M.; Kruslin, B.. "Immunohistochemical analysis of ER, PR, HER-2, CK 5/6, p63 and EGFR antigen expression in medullary breast cancer.". Tumori 94 (6): 838-44. PMID 19267102.