Prognostic comparison of three classifications for medullary carcinoma of the breast

Pedersen,; Holck,; Mouridsen,; Schiødt,; Zedeler,

doi:10.1046/j.1365-2559.1999.00584.x

Cited by 7 publications

(4 citation statements)

References 8 publications

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“…A "medullary" appearance with a sheet-like proliferation of tumor cells, pushing borders, necrosis, and prominent peri-and intra-tumoral lymphocytes has also been described (Figure 1). Of note, classical criteria for medullary carcinoma of the breast include syncytial architecture composing >75% of the tumor mass, histological circumscription with pushing margins, lack of tubular differentiation and in situ carcinoma, a prominent and diffuse lymphocytic infiltrate, and round tumor cells with abundant cytoplasm and pleomorphic high-grade vesicular nuclei containing one or several nucleoli (28,29). Given that these diagnostic criteria are difficult to apply and lead to high interobserver variability, the World Health Organization (WHO) proposes the term "invasive carcinoma of no special type with medullary pattern" to describe a tumor exhibiting some or all of the above characteristics (30).…”

Section: Brca1-associated Breast Cancermentioning

confidence: 99%

Pathology of Hereditary Breast and Ovarian Cancer

Hodgson

Turashvili

2020

Front. Oncol.

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Hereditary breast and ovarian cancer (HBOC) syndrome is most commonly characterized by deleterious germline mutations in BRCA1 and BRCA2. HBOC patients are prone to the development of malignant neoplasms in multiple organs including the breast, ovary, and fallopian tube. From a pathological perspective, a number of morphological features have been described in BRCA-associated breast and tuboovarian cancers. For example, breast cancers diagnosed in BRCA1-mutation carriers are frequently of a high Nottingham grade and display medullary morphology and a triple-negative and/or a basal-like immunophenotype. In contrast, breast cancers in BRCA2-mutation carriers are similar to sporadic luminal-type tumors that are positive for hormone receptors and lack expression of human epidermal growth factor receptor 2. Cancers arising in the fallopian tube and ovary are almost exclusively of a highgrade serous histotype with frequent Solid, pseudo-Endometrioid, and Transitional cell carcinoma-like morphology ("SET features"), marked nuclear atypia, high mitotic index, abundant tumor infiltrating lymphocytes, and necrosis. In addition, pushing or infiltrative micropapillary patterns of invasion have been described in BRCA-associated metastases of tubo-ovarian high-grade serous carcinomas. Besides BRCA1 and BRCA2 mutations, alterations in a number of other homologous recombination genes with moderate penetrance, including PALB2, RAD51C, RAD51D, BRIP1, and others, have also been described in HBOC patients with varying frequency; however, distinct morphological characteristics of these tumors have not been well characterized to date. In this review, the above pathological features are discussed in detail and a focus is placed on how accurate pathologic interpretation plays an important role in allowing HBOC patients to receive the best possible management.

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Section: Brca1-associated Breast Cancermentioning

confidence: 99%

Pathology of Hereditary Breast and Ovarian Cancer

Hodgson

Turashvili

2020

Front. Oncol.

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“…They account for 1.1–7% of all mammary carcinomas 1–4 and tend to affect patients of younger age 1 . Despite their aggressive morphology, with nuclear atypia and high mitotic indices, MCs are paradoxically associated with a good prognosis 5–7 . Diagnosis is based on specific histopathological criteria, 7,8 but although these have been well established, diagnosis appears to be difficult 6,9,10 .…”

Section: Introductionmentioning

confidence: 99%

“…Despite their aggressive morphology, with nuclear atypia and high mitotic indices, MCs are paradoxically associated with a good prognosis 5–7 . Diagnosis is based on specific histopathological criteria, 7,8 but although these have been well established, diagnosis appears to be difficult 6,9,10 . Particularly in cases of high‐grade invasive ductal carcinomas of the breast (IDCs) sharing medullary features, i.e.…”

Section: Introductionmentioning

confidence: 99%

Distinguishing medullary carcinoma of the breast from high‐grade hormone receptor‐negative invasive ductal carcinoma: an immunohistochemical approach

Flucke

Hoy

et al. 2010

Histopathology

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“…20) 또한 수질성 유방암은 일반적으로 높은 핵등급 및 조직학적 등급을 갖는 것으로 알려져 있지만, 예후에 있어서는 오히려 다른 침윤성 유방암종에 비해 대체로 양호하다는 보고가 있고, 11,21,22) 이와는 다르게 예후에 있어 서는 크게 유리하지 않다는 보고도 있다. 17) 이러한 차이는 앞에서 언급한 것과 같이 수질성 유방암의 진단기준의 차이에서 비롯된 다고 할 수 있다. 15,16,23) 일반적으로 ER이 양성인 유방암의 경우 음성인 경우보다 2-3년 내에 재발의 가능성이 적어서 전체적인 예후가 좋은 것으로 알려 져 있으며, 분화도가 좋을수록 ER 양성율은 증가한다고 한다.…”

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Expression of ER, p53 and HER-2/neu in medullary carcinoma and infiltrating ductal carcinoma with medullary feature

이종은¹,

이지현²,

한선욱³

et al. 2010

Korean J Clin Oncol

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Purpose : Breast cancer with BRCA1 variation has similar microscopic appearance with medullary cancer, and has pushing margins. These cases are classified as infiltrating ductal carcinoma with medullary general, medullary cancer expresses p53 and negative HER-2/neu. Positive ER is related to good prognosis, and well differentiated cancer is related to positive predictive value. Based on these correlations, the study was designed to make differentiation between medullary cancer and infiltrating ductal carcinoma with medullary feature with expression of ER, p53, and HER-2/neu. Material and Methods : Specimen of 10 medullary cancer and 20 infiltrating ductal carcinoma with medullary feature, which were obtained from biopsy or operation at breast clinic in Soonchunhyang university Cheonan hospital underwent immunohistochemistry stain.Results : ER expression in medullary cancer was negative in 9 out of 10 cases. In infiltrating ductal carcinoma with medullary feature, it was negative in 14 out of 20 cases, and there was expression of grade 3 in 5 cases. Expression of p53 in medullary cancer was grade 1 in 5, and grade 3 in 5 among 10 cases. In infiltrating ductal carcinoma with medullary feature, it was grade 1 in 7, and grade 3 in 11 among 20 cases. The expression of HER-2/neu in medullary cancer was score 0 in 2, and score 3 in 4 among 10 cases. It was expressed as score 0 in 8, and score 3 in 10 among 20 cases with infiltrating ductal carcinoma with medullary feature. Conclusion : Expression of p53 and HER-2/neu was not useful in differentiating medullary cancer and infiltrating ductal carcinoma with medullary feature. ER was useful only in cases with positive ER expression. Microscopic findings of necrosis and stromal feature, or ultrasonographic findings of tumor margin was considered to be more valuable in discriminating the 2 diseases.

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Prognostic comparison of three classifications for medullary carcinoma of the breast

Cited by 7 publications

References 8 publications

Pathology of Hereditary Breast and Ovarian Cancer

Pathology of Hereditary Breast and Ovarian Cancer

Distinguishing medullary carcinoma of the breast from high‐grade hormone receptor‐negative invasive ductal carcinoma: an immunohistochemical approach

Expression of ER, p53 and HER-2/neu in medullary carcinoma and infiltrating ductal carcinoma with medullary feature

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