Clinical Analysis of Typical Medullary Carcinoma of the Breast

Choi, Kyu Hwan; Noh, Woo Chul; Paik, Nam Sun; Moon, Nan Mo; Bang, Ho Yoon; Choi, Dong Wook; Lee, Jong Inn; Moon, Seon Mi

Abstract

PURPOSE
Medullary carcinoma of the breast is an uncommon subtype of infiltrating ductal carcinoma and its incidence in different series ranges between 2% and 8% of all breast canoers. The histopathologic criteria for medullary carcinoma of the breast used by most pathologists today were delineated by Ridolfi et al. in 1977. The criteria of typical medullary carcinoma include all of followings: 75% or more of syncytial growth pattern, microscopically completely circumscribed, no intraductal component, moderate to marked diffuse mononuclear stromal invasion, nuclear grade 1 or 2. Medullary carcinoma has a more favorable prognosis than usual invasive breast cancer. MATERIALS & METHODS: To determine clinical characteristics of this tumor, the medical records of 15 women with typical medullary carcinoma treated at KCCH between 1985 and 1996 were reviewed retrospectively.
RESULTS
The incidence of typical medullary carcinoma in KCCH was 0.51%(15/2946) of all breast cancers. Age ranged from 27 to 56 years and mean age was 40.1 years. The peak age group was 4th decade(46.6%), followed by 5 th decade(40%). Most of the patients were premenopausal status(14/15). The major clinical manifestation of all patients was a palpable mass. Twelve patients were investigated for ER status, but all were negative. Preoperative fine needle aspiration cytology was checked in 6 patients, all cases showed positive findings for malignancy. The mean size of tumor was 3.01 cm in diameter and the rate of lymph node positivity was 40%(6/15). There was one case of systemic recurrence at 38 months after operation and the patient expired at 3 months after detection of recurrence. The others were alive without evidence of disease for mean follow-up period of 64.7 months.
CONCLUSIONS
The mean age of the patients of medullary carcinoma was relatively younger than that of the patients with other usual invasive breast cancer. The incidence of medullary carcinoma in this study was slightly lower than western series. Medullary carcinoma showed good prognosis, even if estrogen receptors were negative, but to determine clinical characteristics of Korean medullary carcinoma of the breast, multicenter data should be collected.