breast medullary carcinoma

Medullary Breast Carcinoma: A Rare and Distinct Subtype

Medullary breast carcinoma is a rare subtype of invasive breast cancer, accounting for less than 5% of all invasive breast cancers [1]. It is characterized by its distinct histological features, which set it apart from other types of breast cancer.

Key Characteristics

• Well-circumscribed borders: Medullary breast cancer typically has a clear, well-defined border between the cancer and the surrounding breast tissue [7].
• Poorly differentiated cells: The tumor is composed of poorly differentiated cells with abundant cytoplasm and pleomorphic high-grade vesicular nuclei [3].
• Lymphocytic infiltration: There is significant lymphocytic (white blood cell) infiltration in and around the tumor [4].
• Soft, fleshy appearance: The tumor has a soft, fleshy appearance, which resembles the soft gray matter in the brain stem [2].

Symptoms

Medullary breast cancer may present with various symptoms, including:

• A lump or thickening in the breast
• Changes to the nipple (such as puckering or dimpling of the skin)
• Pain in the breast (although this is not always a symptom) [4]

Diagnosis and Treatment

If you're diagnosed with medullary breast cancer, it's essential to seek treatment from a qualified breast cancer specialist. The diagnosis is typically made through histological examination of the tumor tissue.

While there are no specific guidelines for treating medullary breast cancer, treatment options may include surgery, radiation therapy, and/or chemotherapy [5].

References

[1] Medullary carcinoma is a rare and distinct subgroup of breast carcinomas accounting for less than 5% of all invasive breast cancers.[1] [2] The term medullary refers to the tumor's soft, fleshy appearance, which resembles the soft gray matter in the brain stem ... [3] It is histologically characterized as poorly differentiated cells with abundant cytoplasm and pleomorphic high-grade vesicular nuclei. [3] [4] A lump or thickening · A change in the size of the breast · Changes to the nipple · Puckering or dimpling of the skin · Pain in the breast (this is usually not a ... [5] by MP, et al., "Medullary carcinoma of the breast: A review of the literature"

Differential Diagnosis of Breast Medullary Carcinoma

Breast medullary carcinoma (MBC) is a rare and distinct subgroup of breast carcinomas, accounting for less than 5% of all invasive breast cancers. Due to its unique histologic features, differential diagnosis of MBC can be challenging.

Key Features to Consider:

• Complete circumscription: MBC typically presents as a well-circumscribed mass.
• Syncytial growth pattern: The tumor cells are arranged in a syncytial pattern, with a high nuclear grade.
• Associated lymphocytic infiltrate: A diffuse lymphocytic infiltrate is often present around the tumor.
• Lack of coexistent in situ component: MBC lacks a coexistent in situ component.

Differential Diagnoses:

• Invasive breast carcinoma with medullary pattern: This subtype can be challenging to distinguish from MBC, as it also presents with a syncytial growth pattern and associated lymphocytic infiltrate.
• Chronic inflammation: Chronic inflammation can mimic the appearance of MBC on imaging studies.
• Lymphoma: Lymphoma can present as a well-circumscribed mass, similar to MBC.
• Melanoma: Melanoma can also present with a syncytial growth pattern and associated lymphocytic infiltrate.

Other Considerations:

• Histopathological overlap: MBC often shows histopathological overlap with other subtypes of breast cancer, making differential diagnosis challenging.
• Imaging characteristics: MBC typically presents as a well-circumscribed mass on imaging studies, but can also have a spiculated appearance.

References:

[4] Medullary carcinoma of the breast (MCB) is an uncommon subtype of breast cancer and accounts for ~5% 1,4 of all breast cancers. [10] Hence, we should keep in mind this type of carcinoma in the differential diagnosis of fibroadenoma.[10,13] [14] Medullary carcinoma (MC) is a rare subtype of invasive ductal carcinoma (IDC) of the breast, accounting for 3-6% of all breast cancers and 10% of those in women under 35. [15] Our study aimed to compare the differences in clinical characteristics and prognosis between MBC and invasive ductal carcinoma (IDC), and to further develop and validate nomograms to predict overall survival (OS) and cancer-specific survival (CSS) in MBC patients.