Medullary breast carcinoma
|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|
|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.
- Uncommon breast cancer subtype.
- Some pathologists very rarely make the diagnosis.
- Thought to have a better prognosis that no special type (NST).
- May be associated with a BRCA1 mutation.
- Well-circumscribed border.
Aside - malignant well-circumscribed breast masses - radiologic DDx:
- Medullary breast carcinoma.
- Mucinous breast carcinoma.
- Malignant phyllodes tumour.
- Invasive papillary carcinoma of the breast.
- Lesion has well-circumscribed border.
- Syncytial growth pattern = clumps of cells with poorly defined cell borders.
- Lymphocytic infiltrate.
- High nuclear grade (as per Nottingham grading system).
- No tubule formation.
- Invasive ductal carcinoma with medullary features.
Features - typical:
- ER -ve.
- PR -ve.
- HER2 -ve.
- 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.
- 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.