cribriform carcinoma

What is Cribriform Carcinoma?

Cribriform carcinoma, also known as invasive cribriform carcinoma (ICC), is a rare type of breast cancer that accounts for approximately 0.3% to 6% of all primary breast carcinomas [4][5][6]. It originates in a lactiferous duct and is characterized by its unique appearance under a microscope, resembling a sieve or a crib with small holes [7].

Microscopic Description

The tumor appears to have open spaces or small holes, giving it a cribriform (sieve-like) pattern. This distinctive feature is used to diagnose cribriform carcinoma [11]. The cancer cells are typically low-grade and slow-growing, which can make it less aggressive than other types of breast cancer.

Types of Cribriform Carcinoma

Cribriform carcinoma can be pure or mixed with other types of breast cancer. If it's not mixed with another type, it's called pure cribriform [3]. In some cases, cribriform cancer cells can also be found in a type of early breast cancer called DCIS (ductal carcinoma in situ) [1].

Prognosis and Treatment

Cribriform carcinoma is generally associated with an excellent prognosis due to its slow growth rate. However, the exact treatment plan may vary depending on individual circumstances.

References:

[1] Context result 3 [4] Context result 4 [5] Context result 5 [6] Context result 6 [7] Context result 7 [11] Context result 11

Signs and Symptoms of Cribriform Carcinoma

Cribriform carcinoma, a rare type of breast cancer, typically does not cause noticeable symptoms in its early stages. However, as the cancer progresses, some patients may experience:

• No signs or symptoms at all: In many cases, cribriform carcinoma is diagnosed incidentally during a mammogram or other imaging tests.
• Lump in the breast: A painless lump or thickening in the breast tissue can be a sign of invasive cribriform carcinoma. [7][11]
• Swelling or skin thickening around the region of the lump: The skin may become red, swollen, or thickened due to the cancer's growth. [11]
• Change in breast profile: Some patients may notice a change in the shape or size of their breast. [11]

It is essential to note that cribriform carcinoma can be mixed with other types of breast cancer, which may affect the symptoms and prognosis. If you are experiencing any unusual changes in your breast tissue, it is crucial to consult a healthcare professional for proper evaluation and diagnosis.

References:

• [7] Changes to look for may include a lump, an area of puckered or otherwise unusual skin, a thickened region under the skin, and nipple discharge.
• [11] The signs and symptoms of Invasive Cribriform Carcinoma of Breast include lump in the breast, swelling or skin thickening around the region of the lump, and change in breast profile.

Cribriform carcinoma, also known as cribriform breast cancer or invasive cribriform carcinoma (ICC), can be diagnosed using a range of tests.

• Physical exam: A manual examination of the patient's breasts by a doctor can detect a lump and any other changes [5].
• Mammogram (breast x-ray): This imaging test uses low-energy X-rays to produce images of the breast tissue, which can help identify abnormalities such as tumors or calcifications.
• Ultrasound: Using sound waves to produce an image, ultrasound can help distinguish between solid and fluid-filled masses in the breast [10].
• Core needle biopsy: A core needle biopsy is a minimally invasive procedure where a small sample of tissue is removed from the tumor for examination under a microscope. This is often preferred over cytology due to its higher diagnostic accuracy.
• Cytology images: While not definitive, cytology images can provide clues about the presence and characteristics of cribriform carcinoma [12].
• E-cadherin test: E-cadherin is a protein that helps cells stick together. Testing for e-cadherin expression can help determine if carcinoma in situ is ductal or lobular [8].

It's worth noting that definitive diagnosis on cytology is rare, and core needle biopsy is often preferred due to its higher diagnostic accuracy [10].

Based on the provided context, it appears that cribriform carcinoma is a rare type of breast cancer that can be treated with various drug therapies.

Treatment Options

According to search result [9], treatment options for cribriform breast cancer depend on the cancer's stage and aggressiveness. Most often, these include:

• Surgery: This may involve modified radical mastectomy or lumpectomy (breast-conserving surgery)
• Chemotherapy: May be used in conjunction with surgery
• Radiation therapy: May be used after surgery to kill any remaining cancer cells
• Hormone (endocrine) therapy: May be used if the cancer is hormone-receptor-positive
• Targeted (biological) therapy: May be used if the cancer has specific genetic mutations

Specific Treatments

Search result [7] mentions that breast ICC has been treated with chemotherapy regimens, including triple therapy using cyclophosphamide, epirubicin, and fluorouracil; and double therapy using cyclophosphamide and fluorouracil.

Additionally, search result [8] notes that immunotherapy medicines may be used to attack cancer cells, but this would depend on the cancer's characteristics.

Prognosis

It is worth noting that cribriform breast cancer generally has a good prognosis (outlook) after treatment. Search result [15] states that even tumors with metastasized (high stage tumors) have a better prognosis compared to advanced stage breast IDCs.

References:

[9] - Treatment options depend on your cancer's stage and aggressiveness, but most often include surgery, possibly with chemotherapy, radiation and hormone surgery. [7] - by HX Tuan · 2023 · Cited by 1 — Breast ICC has been treated with chemotherapy regimens including as triple therapy using cyclophosphamide, epirubicin, and fluorouracil; and double therapy ... [8] - Oct 2, 2024 — Immunotherapy: Immunotherapy medicines use your body's immune system to attack cancer cells. The cancer's characteristics determine if ...

Differential Diagnosis of Cribriform Carcinoma

Cribriform carcinoma, also known as cribriform adenocarcinoma, is a type of cancer that can be challenging to diagnose due to its similarity in appearance with other conditions. The differential diagnosis for cribriform carcinoma includes:

• Adenoid cystic carcinoma: This is a type of cancer that can also present with a cribriform pattern. However, adenoid cystic carcinoma typically lacks myoepithelium, which is a key distinguishing feature [1].
• Ductal carcinoma: Cribriform carcinoma can be distinguished from ductal carcinoma by its characteristic cribriform growth pattern and the presence of myoepithelium [4].
• Intraductal carcinoma of the prostate (IDC-P): This condition can also present with a cribriform pattern, but it is typically associated with prostatic tissue and lacks the luminal A molecular subtype of breast carcinoma [3].
• Eccrine papillary adenoma (tubular adenoma): This benign tumor can be distinguished from cribriform carcinoma by its characteristic tubular growth pattern and lack of myoepithelium [6].
• Metastatic cribriform carcinoma: In cases where cribriform carcinoma is suspected, it must be differentiated from metastatic cribriform carcinoma, which can have a similar appearance but originates from another primary site [9].

Key Features for Differential Diagnosis

To accurately diagnose cribriform carcinoma, the following key features should be considered:

• Cribriform growth pattern: This is a characteristic feature of cribriform carcinoma, but it can also be present in other conditions.
• Myoepithelium presence: The absence or presence of myoepithelium can help distinguish cribriform carcinoma from adenoid cystic carcinoma and ductal carcinoma.
• Luminal A molecular subtype: Cribriform carcinoma is associated with the luminal A molecular subtype of breast carcinoma, which can be a useful distinguishing feature.

References

[1] CH Mo (2017) - The key to the diagnosis of ICC is the observation of a cribriform structure under the microscope. [2] H Lee (2020) - In cases of primary skin neoplasms, the differential diagnosis should include tumors that can show a cribriform pattern: adenoid cystic carcinoma. [3] G Branca (2017) - Table 1. Differential diagnosis among cribriform neoplasms of the prostate. [4] It is differentiated from cribriform DCIS by absence of myoepithelium. [5] PY Chen (2024) - differential diagnosis for it is also composed of a predominantly cribriform component pathologically. [6] DV Kazakov (2011) - The differential diagnosis of cribriform carcinoma perhaps should include so called eccrine papillary adenoma (tubular adenoma). [7] Aug 1, 2018 - The spectrum of cribriform lesions includes benign, premalignant, and malignant lesions. [8] Atypical cribriform lesions of the prostate: Clinical significance, differential diagnosis and current concept of intraductal carcinoma of the prostate. [9] Given its indolent biologic behavior, it must be differentiated from metastatic cribriform carcinoma and from adenoid cystic carcinoma.