Medullary Carcinomas

Medullary carcinoma is described in the WHO analysis of breast tumors as a “well circumscribed carcinoma comprised of poorly discriminate cells with scant stroma and renowned lymphoid infiltration.” The analysis of “true” medullary carcinoma compels the precise application of diagnostic criteria; when this is done accurately, it may establish approximately 5% of breast carcinomas. Like others, I consider that tumors with peculiar features (i.e., atypical medullary carcinoma) are best recognized invasive ductal carcinoma of no special type until additional studies indicate variously. Medullary carcinomas are politely delineated tumors with a good diagnosis even though a poorly diversified appearance. The pathologist must be definite that they are handling with a pure medullary carcinoma, and not an invasive ductal carcinoma with medullary features, because the recent has a prognosis related to invasive ductal cancer. Medullary carcinoma is usually overdiagnosed. There are precise criteria that must be met to call a cancer medullary. Medullary carcinomas are more common in younger women, as well as in both Japanese and African-American women in the United States. Because they are so well circumscribed, they are often distracted for fibroadenomas. Prognosis is good, even when lymph node reflection is present. Not uncommonly, medullary carcinomas are correlated with a reactive lymphadenopathy that may be involved for clinical nodal involvement.          

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