Clinicopathological Study Of Medullary Breast Carcinoma: An Instututional Study
Keywords:
Medullary, breast carcinoma, typical, atypical, histopathology, immunohistochemistry
Abstract
Background: Medullary breast carcinoma (MBC) is a rare distinct type of invasive breast carcinoma with incidence being less than 5%. It usually occurs under the age of 50 years, often mistaken clinically for fibroadenoma. They are divided into typical, and atypical MBC with a prerequisite of syncytial growth pattern in more than 75% of the tumor cells. MBCs are often hormone (ER, PR, Her2/neu) negative with grade 3 Nottingham’s criteria but have better prognosis.Methods: Retrospective study of invasive carcinoma of the breast was undertaken in pathology department from 2009-2016. Total number of invasive breast carcinoma were 388, of which MBC were 12 cases histologically.Clinical details, gross features were noted. HPE and IHC (ER, PR, Her2/neu) slides were reviewed.Result: Age range was 35 to 64 years, with (mean 49.08). All presented clinically as solitary lump in breast. No side predilection. Most common site affected was upper inner quadrant consitituing around 50%(6 out of 12) of cases. Overall tumour size ranged from 2.5 to 6 cms with a mean of 3.6cms in typical and 4.25 cms in atypical MBC. Grossly majority of the tumors were soft to firm in consistency. Histologically 10 out of 12 cases ( 83.3%) were typical MBC and 2 cases were atypical MBC(16.7%).IHC showed triple negativity in 75% of MBC with majority in typical MBC (80 %)Conclusion: MBC is unique type of breast carcinoma with good prognosis. Histopathology plays important role in diagnosing variants of MBC since the treatment differs.DOI: 10.21276/APALM.1634References
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11. Rosen PP, Lesser ML, Kinne DW, et al. Discontinuous or “skip” metastases in breast carcinoma. Ann Surg 1983;197:276–283.
12. Dabbs DJ, Specail types of invasive breast carcinoma. In Breast pathology.2nd edition, Elseiver, Philadelphia,2017:639-662.
13. Santosh T, Bal AK, Patro MK, Choudhury A. Medullary Breast Carcinoma: A Case Report and Review of Literature. J Cancer SciTher 2015;7: 142-144.
14. Rosen PP. Medullary Carcinoma. In Rosen™ Breast Pathology. 3rd edition, Lippincott Williams & Wilkins, Philadelphia, 2009: 449-466.
15.Mateo AM, Pezzi TA, Sundermeyer M, Kelly C, Klimberg VS, Pezzi CM. Atypical medullary carcinoma of the breast has similar prognostic factors and survival to typical medullary carcinoma:3976 cases from the national cancer data base. J SurgOncol 2016;114(5):533-536.
16.Patil SM, Bhatia A, Karthik K, Umeshchandra DG. Medullary carcinoma breast: A case report. Sch. J. App. Med. Sci., 2013; 1(6):681-683
2. Chu Z, Lin H, Liang X, Huang R, Zhan Q, Jiang J et al. Clinicopathological characteristics of Typical medullary breast carcinoma: A retrospective study of 117 cases.PLoS ONE 2014;9(11): E111493.
3. Juan R, Breast In Rosai and Ackerman's surgical pathology. 10th edition, Elsiever,Mosby,2011:1660-1773.
4.Tavasolli FA, Devilee P. World health organization classification of tumors,Pathology and genetics of tumors of breast and female genital organs. Lyon: IARC press;2003.
5. Marginean F, Rakha AE, Ho BC, Ellis IO, Lee AH. Histological features of medullary carcinoma and prognosis in triple negative basal like carcinomas of the breast. Modern pathology 2010;23:1357-63.
6. Sloane JP. Biopsy pathology of the breast. 2nd edition. New York : Oxford University Press;2001.
7. Moore OS, Foote FW. The relatively favourable prognosis of medullary carcinoma of the breast. Cancer 1949;2(4):635-64.
8. Chetty R. Gastrointestinal cancers accompanied by a dense lymphoid component: an overview with special reference to gastric and colonic medullary and lymphoepithelioma-like carcinomas. ClinPathol 2012;65:1062–1065.
9. Ridolfi RL, Rosen PP, Port A, et al. Medullary carcinoma of the breast: a clinicopathological study with 10 year follow-up. Cancer 1977;40(4):1365-1385.
10. Kleer CG. Carcinoma of the breast with medullary-like features Diagnostic challenges and relationship with BRCA1 and ERH2 functions. Arch Pathol Lab med 2009;133:1822-1825.
11. Rosen PP, Lesser ML, Kinne DW, et al. Discontinuous or “skip” metastases in breast carcinoma. Ann Surg 1983;197:276–283.
12. Dabbs DJ, Specail types of invasive breast carcinoma. In Breast pathology.2nd edition, Elseiver, Philadelphia,2017:639-662.
13. Santosh T, Bal AK, Patro MK, Choudhury A. Medullary Breast Carcinoma: A Case Report and Review of Literature. J Cancer SciTher 2015;7: 142-144.
14. Rosen PP. Medullary Carcinoma. In Rosen™ Breast Pathology. 3rd edition, Lippincott Williams & Wilkins, Philadelphia, 2009: 449-466.
15.Mateo AM, Pezzi TA, Sundermeyer M, Kelly C, Klimberg VS, Pezzi CM. Atypical medullary carcinoma of the breast has similar prognostic factors and survival to typical medullary carcinoma:3976 cases from the national cancer data base. J SurgOncol 2016;114(5):533-536.
16.Patil SM, Bhatia A, Karthik K, Umeshchandra DG. Medullary carcinoma breast: A case report. Sch. J. App. Med. Sci., 2013; 1(6):681-683
Published
2018-01-28
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