Clinical analysis of medullary carcinoma of the breast

Jae Won Oh, Seho Park, Joo Hee Kim, Ja Seung Koo, Ho Hur, Woo Ick Yang, Byeong Woo Park, Kyong Sik Lee

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: Medullary carcinoma of the breast is a variant of breast cancer characterized by the histologic appearance of poorly differentiated cells surrounded by a prominent lymphoid stroma. Medullary carcinoma has been reported to carry a prognosis better than other invasive breast carcinomas, but it is frequently overdiagnosed due to the difficulty in diagnosis. The aim of this study was to assess the clinical manifestations and outcome of medullary carcinoma of the breast. Methods: We reviewed the data of 91 patients diagnosed with medullary carcinoma and 3,743 patients with invasive ductal carcinoma, not otherwise specified (NOS) from January 1980 to December 2005 at Yonsei University Severance Hospital. The clinicopathologic features, disease free survival (DFS) and overall survival (OS) for patients with medullary carcinoma were compared with those of the NOS patients. Results: With reviewing the pathologic slides, 69 (75.8%) patients had findings compatible with typical medullary carcinoma (TMC) and the remaining 22 (24.2%) patients were reclassified as atypical medullary carcinoma (AMC). Early stage cancer was more frequent at medullary carcinoma and lymph node positive cancer was less frequent at medullary carcinoma. The expression of ER/PR was positive in either the TMC (18.9%/16.2%) and AMC (15.0%/20.0%) as compared to the NOS (63.2%/57.2%), and the difference was significant (p<0.001). In contrast, the HER-2/neu expression rate was significantly higher in the TMC (47.4%) and AMC (45.5%) than in the NOS (28.3%, p=0.001). The 10-year disease free survival and 10-year overall survival of the atypical medullary carcinoma patients (67.8%, 77.8%) were in fact similar to the NOS carcinoma patients (68.3%, 74.7%). There was significant difference in 10-year disease free survival and 10-year overall survival between the TMC (77.8%, 86.0%) and NOS carcinoma (68.3%, 74.7%) patients (p=0.002, p=0.006). Conclusion: The clinical outcome of typical medullary carcinoma is favorable in spite of its aggressive pathologic features and it differs from atypical medullary carcinoma. For precise prediction of prognosis of medullary cancer, we should apply strict criteria for the diagnosis of subtype with medullary features.

Original languageEnglish
Pages (from-to)47-53
Number of pages7
JournalJournal of Breast Cancer
Volume12
Issue number1
DOIs
Publication statusPublished - 2009 Mar 1

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Medullary Carcinoma
Breast
Disease-Free Survival
Survival
Breast Neoplasms
Carcinoma
Neoplasms
Ductal Carcinoma

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Oh, J. W., Park, S., Kim, J. H., Koo, J. S., Hur, H., Yang, W. I., ... Lee, K. S. (2009). Clinical analysis of medullary carcinoma of the breast. Journal of Breast Cancer, 12(1), 47-53. https://doi.org/10.4048/jbc.2009.12.1.47
Oh, Jae Won ; Park, Seho ; Kim, Joo Hee ; Koo, Ja Seung ; Hur, Ho ; Yang, Woo Ick ; Park, Byeong Woo ; Lee, Kyong Sik. / Clinical analysis of medullary carcinoma of the breast. In: Journal of Breast Cancer. 2009 ; Vol. 12, No. 1. pp. 47-53.
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title = "Clinical analysis of medullary carcinoma of the breast",
abstract = "Purpose: Medullary carcinoma of the breast is a variant of breast cancer characterized by the histologic appearance of poorly differentiated cells surrounded by a prominent lymphoid stroma. Medullary carcinoma has been reported to carry a prognosis better than other invasive breast carcinomas, but it is frequently overdiagnosed due to the difficulty in diagnosis. The aim of this study was to assess the clinical manifestations and outcome of medullary carcinoma of the breast. Methods: We reviewed the data of 91 patients diagnosed with medullary carcinoma and 3,743 patients with invasive ductal carcinoma, not otherwise specified (NOS) from January 1980 to December 2005 at Yonsei University Severance Hospital. The clinicopathologic features, disease free survival (DFS) and overall survival (OS) for patients with medullary carcinoma were compared with those of the NOS patients. Results: With reviewing the pathologic slides, 69 (75.8{\%}) patients had findings compatible with typical medullary carcinoma (TMC) and the remaining 22 (24.2{\%}) patients were reclassified as atypical medullary carcinoma (AMC). Early stage cancer was more frequent at medullary carcinoma and lymph node positive cancer was less frequent at medullary carcinoma. The expression of ER/PR was positive in either the TMC (18.9{\%}/16.2{\%}) and AMC (15.0{\%}/20.0{\%}) as compared to the NOS (63.2{\%}/57.2{\%}), and the difference was significant (p<0.001). In contrast, the HER-2/neu expression rate was significantly higher in the TMC (47.4{\%}) and AMC (45.5{\%}) than in the NOS (28.3{\%}, p=0.001). The 10-year disease free survival and 10-year overall survival of the atypical medullary carcinoma patients (67.8{\%}, 77.8{\%}) were in fact similar to the NOS carcinoma patients (68.3{\%}, 74.7{\%}). There was significant difference in 10-year disease free survival and 10-year overall survival between the TMC (77.8{\%}, 86.0{\%}) and NOS carcinoma (68.3{\%}, 74.7{\%}) patients (p=0.002, p=0.006). Conclusion: The clinical outcome of typical medullary carcinoma is favorable in spite of its aggressive pathologic features and it differs from atypical medullary carcinoma. For precise prediction of prognosis of medullary cancer, we should apply strict criteria for the diagnosis of subtype with medullary features.",
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Oh, JW, Park, S, Kim, JH, Koo, JS, Hur, H, Yang, WI, Park, BW & Lee, KS 2009, 'Clinical analysis of medullary carcinoma of the breast', Journal of Breast Cancer, vol. 12, no. 1, pp. 47-53. https://doi.org/10.4048/jbc.2009.12.1.47

Clinical analysis of medullary carcinoma of the breast. / Oh, Jae Won; Park, Seho; Kim, Joo Hee; Koo, Ja Seung; Hur, Ho; Yang, Woo Ick; Park, Byeong Woo; Lee, Kyong Sik.

In: Journal of Breast Cancer, Vol. 12, No. 1, 01.03.2009, p. 47-53.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical analysis of medullary carcinoma of the breast

AU - Oh, Jae Won

AU - Park, Seho

AU - Kim, Joo Hee

AU - Koo, Ja Seung

AU - Hur, Ho

AU - Yang, Woo Ick

AU - Park, Byeong Woo

AU - Lee, Kyong Sik

PY - 2009/3/1

Y1 - 2009/3/1

N2 - Purpose: Medullary carcinoma of the breast is a variant of breast cancer characterized by the histologic appearance of poorly differentiated cells surrounded by a prominent lymphoid stroma. Medullary carcinoma has been reported to carry a prognosis better than other invasive breast carcinomas, but it is frequently overdiagnosed due to the difficulty in diagnosis. The aim of this study was to assess the clinical manifestations and outcome of medullary carcinoma of the breast. Methods: We reviewed the data of 91 patients diagnosed with medullary carcinoma and 3,743 patients with invasive ductal carcinoma, not otherwise specified (NOS) from January 1980 to December 2005 at Yonsei University Severance Hospital. The clinicopathologic features, disease free survival (DFS) and overall survival (OS) for patients with medullary carcinoma were compared with those of the NOS patients. Results: With reviewing the pathologic slides, 69 (75.8%) patients had findings compatible with typical medullary carcinoma (TMC) and the remaining 22 (24.2%) patients were reclassified as atypical medullary carcinoma (AMC). Early stage cancer was more frequent at medullary carcinoma and lymph node positive cancer was less frequent at medullary carcinoma. The expression of ER/PR was positive in either the TMC (18.9%/16.2%) and AMC (15.0%/20.0%) as compared to the NOS (63.2%/57.2%), and the difference was significant (p<0.001). In contrast, the HER-2/neu expression rate was significantly higher in the TMC (47.4%) and AMC (45.5%) than in the NOS (28.3%, p=0.001). The 10-year disease free survival and 10-year overall survival of the atypical medullary carcinoma patients (67.8%, 77.8%) were in fact similar to the NOS carcinoma patients (68.3%, 74.7%). There was significant difference in 10-year disease free survival and 10-year overall survival between the TMC (77.8%, 86.0%) and NOS carcinoma (68.3%, 74.7%) patients (p=0.002, p=0.006). Conclusion: The clinical outcome of typical medullary carcinoma is favorable in spite of its aggressive pathologic features and it differs from atypical medullary carcinoma. For precise prediction of prognosis of medullary cancer, we should apply strict criteria for the diagnosis of subtype with medullary features.

AB - Purpose: Medullary carcinoma of the breast is a variant of breast cancer characterized by the histologic appearance of poorly differentiated cells surrounded by a prominent lymphoid stroma. Medullary carcinoma has been reported to carry a prognosis better than other invasive breast carcinomas, but it is frequently overdiagnosed due to the difficulty in diagnosis. The aim of this study was to assess the clinical manifestations and outcome of medullary carcinoma of the breast. Methods: We reviewed the data of 91 patients diagnosed with medullary carcinoma and 3,743 patients with invasive ductal carcinoma, not otherwise specified (NOS) from January 1980 to December 2005 at Yonsei University Severance Hospital. The clinicopathologic features, disease free survival (DFS) and overall survival (OS) for patients with medullary carcinoma were compared with those of the NOS patients. Results: With reviewing the pathologic slides, 69 (75.8%) patients had findings compatible with typical medullary carcinoma (TMC) and the remaining 22 (24.2%) patients were reclassified as atypical medullary carcinoma (AMC). Early stage cancer was more frequent at medullary carcinoma and lymph node positive cancer was less frequent at medullary carcinoma. The expression of ER/PR was positive in either the TMC (18.9%/16.2%) and AMC (15.0%/20.0%) as compared to the NOS (63.2%/57.2%), and the difference was significant (p<0.001). In contrast, the HER-2/neu expression rate was significantly higher in the TMC (47.4%) and AMC (45.5%) than in the NOS (28.3%, p=0.001). The 10-year disease free survival and 10-year overall survival of the atypical medullary carcinoma patients (67.8%, 77.8%) were in fact similar to the NOS carcinoma patients (68.3%, 74.7%). There was significant difference in 10-year disease free survival and 10-year overall survival between the TMC (77.8%, 86.0%) and NOS carcinoma (68.3%, 74.7%) patients (p=0.002, p=0.006). Conclusion: The clinical outcome of typical medullary carcinoma is favorable in spite of its aggressive pathologic features and it differs from atypical medullary carcinoma. For precise prediction of prognosis of medullary cancer, we should apply strict criteria for the diagnosis of subtype with medullary features.

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