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.1634
Highlights
Medullary breast carcinoma (MBC) is a rare, distinct type of invasive breast carcinoma 1 with incidence of less than 5% of invasive breast carcinoma.[1,2] It uusually occurs under age of 50 years, often mistaken clinically for fibroadenoma.[3]
Typical MBC is characterised by a constellation of five histological features, as defined first by Ridolfi et al in 1977.2 These carcinomas are often hormone (ER, PR, Her2/neu) negative with grade 3 Nottinghams criteria,basal phenotype; but have a better prognosis.[2]
Presence of lymphocytes and plasma cells keeps check on MBC and prevents its growth and spread.1Overall five year survival rate is 95% in typical, 80% in atypical medullary carcinoma and 70% in invasive breast carcinoma[6]
Summary
Medullary breast carcinoma (MBC) is a rare, distinct type of invasive breast carcinoma 1 with incidence of less than 5% of invasive breast carcinoma.[1,2] It uusually occurs under age of 50 years, often mistaken clinically for fibroadenoma.[3] MBC are divided into typical and atypical medullary carcinomas , with a prerequisite of syncytial growth pattern in >75% of the tumor cells in both. 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 havebetter prognosis
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