Medullary Carcinoma of Breast: Clinicopathological Study

Abstract

To study the clinical and histopathological features of medullary breast carcinoma (MBC) in rural population in Western Maharashtra. MATERIALS AND METHODS This is a retrospective, analytic study which is done at a tertiary care hospital from March 2010 to April 2016 for a period of 6 years. RESULTS Total of 241 consecutive cases of breast malignancy surgically operated for mastectomy or modified radical mastectomy were studied. From these 241 cases, 11 were reported as medullary carcinoma (constitute 4.56%). From these 11 cases, 10 cases were of typical medullary breast while 1 case was of atypical medullary breast carcinoma was noted. Each case was studied for clinical, morphological, radiological and immunohistochemistry (IHC) findings. For typical medullary carcinoma, the age range in present study was 33 to 55 years with a mean age of 46.3 years. The common clinical presentation was painless lump in the breast with common location being upper outer quadrant. The size of the tumour ranged from 2.5 to 9 cm with a mean size of 5.6 cm. The axillary lymph nodes were involved in 4 (40%) cases. The ER, PR and HER-2 were found to be positive in 10%, 10% and 20% respectively. Triple negative cases were 70%. CONCLUSION The clinicopathological features of medullary breast carcinoma showed early disease stage, having high-grade histological features of tumour, more triple negativity for ER/PR/HER2 and low rate of nodal metastasis.

Clinicopathological Study Of Medullary Breast Carcinoma: An Instututional Study

“…Typically MBCs are almost invariably triple hormone receptor negative, although some typical and atypical MBCs are ER, PR and/or HER-2 positive, indicating the heterogeneity of this type of breast carcinomas. 13 In our study IHC showed triple negativity in 75% cases of MBC (Fig 3) with majority of in typical MBC (80%) similar to study conducted by Jagtap et al 1 .Of the two cases of atypical MBC, one case was ER, PR positive, while Her 2/neu negativity was noted in both.…”

“…10 16.7%, similar to study conducted by Jagtap (Figure 2 F, G). The incidence of atypical MBC was et al 1 Histopathological categorization of atypical www.pacificejournals.com/apalm eISSN: 2349-6983; pISSN: 2394-6466 46%) than in those with atypical medullary carcinomas (30%-52%) or invasive ductal carcinomas (29%-65%). 12 In our study, the number of positive metastatic lymph node involvement were more in atypical MBC (50%) compared to typical MBC.…”

“…14,15 Few cases of atypical MBCs were treated with adjuvant chemotherapy based on Her2 status and lymph node status along with Modified radical al. 1,10 . However the division into typical and atypical MBC has prognostic significance…”

“…5 Presence of lymphocytes and plasma cells keeps check on MBC and prevents its growth and spread. 1 Overall five year survival rate is 95% in typical, 80% in atypical medullary carcinoma and 70% in invasive breast carcinoma 6. . With this background, the current study was undertaken to evaluate the prevalence of MBC and to study the clinicopathological and immunohistochemical profile in typical and atypical MBC.…”

“…Medullary breast carcinoma (MBC) is a rare, distinct type of invasive breast carcinoma 1 with incidence of less 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.…”