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Medullary breast cancer is a predominantly triple-negative breast cancer – histopathological analysis and comparison with invasive ductal breast cancer
Authors:Michał   P. Budzik,Maciej T. Sobieraj,Maria Sobol,Janusz Patera,Aleksandra Czerw,Andrzej Deptał  a,Anna M. Badowska-Kozakiewicz
Affiliation:1.Department of Cancer Prevention, Medical University of Warsaw, Warsaw, Poland;2.Public Central Teaching Clinical Hospital, Warsaw, Poland;3.Department of Pathology, Military Institute of Health Services, Warsaw, Poland;4.Department of Economic and System Analyses, National Institute of Public Health – NIH, Warsaw, Poland;5.Departmet of Health Economics and Medical Law, Medical University of Warsaw, Warsaw, Poland
Abstract:IntroductionMedullary breast cancer (MdBC) is an uncommon type of breast cancer representing 1–7% of all cases. It is characterized by the occurrence of many histopathological features associated with a high grade of malignancy.Material and methodsTwelve MdBCs chosen from a group of 1,122 women suffering from invasive breast cancer were analyzed. Histopathological examination and analysis of a basic molecular profile, i.e. estrogen (ER), progesterone (PR) and HER2 receptor expression, and their comparison with invasive ductal breast cancer (IDC), were performed.ResultsMdBC accounted for 1.07% of all analyzed invasive breast cancer patients. All patients were female, with an average age of 58.54 years. The MdBC group exhibited a larger median tumor diameter (2.05 vs. 1.89 cm), although ≥ T2 tumors comprised 42% vs. 51% for IDCs. Women without regional lymph node involvement (pN0) (83%) formed the largest group. There was a statistically significant difference in the presence of nodal involvement between the studied groups (p < 0.001). Based on the histological grade of malignancy, the majority of MdBC comprised grade II tumors (G2) (93%). In general, MdBC showed statistically higher histologic grade (G1-G3) than IDC (p = 0.003). The 5-year overall survival rate of MdBC patients was 91%. Most MdBCs (92%) were triple-negative, whereas the remaining 8% were HER2 positive.ConclusionsMdBC presented at a younger age than IDC, had a higher histological grade, larger median size and less frequent regional lymph node involvement. Most MdBCs were triple-negative, whereas IDCs were predominantly luminal. Despite numerous aggressive pathological features of MdBC, its clinical outcome and overall prognosis are favorable.
Keywords:HER2   progesterone receptor   estrogen receptor   carcinoma with medullary features
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