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Medullary breast cancer is a very rare type of invasive ductal breast cancer which accounts less than 5% of all breast cancers. Medullary breast cancer is somewhat more common in people who are carriers of a genetic mutation known as BRCA-1.
Like other types of invasive ductal cancer, medullary breast cancer begins in the milk duct of the breast before spreading to the tissues around the duct. It is called “medullary” because when pathologists first looked at these tumors, they were reminded of the grayish soft tissue in the brainstem, or medulla.
Medullary breast cancer behaves somewhat differently than more common types of ductal breast cancer. Though medullary tumors are usually small, the cells are often high grade, which means that they look very different from normal cells and/or are dividing rapidly. Medullary tumors are often “triple-negative”, which means that they test negative for estrogen and progesterone receptors, as well as for the HER2/neu protein. Despite these more aggressive characteristics, medullary tumors are less likely to involve the lymph nodes, are more responsive to treatment, and may have a better prognosis than more common types of invasive ductal cancer.
Local therapy is aimed at preventing the cancer from coming back in the breast. Local therapy includes surgery (lumpectomy or mastectomy), and may include radiation.
Systemic therapy is used to prevent the disease from coming back or spreading to another part of the body. This may include endocrine (hormone) therapy, chemotherapy, and therapy that targets the HER2 protein. Often different types of treatment are used together to achieve the best result.
Your treatment plan will be based on the features of the tumor (type of cells, tumor grade, hormone receptor status, and HER2 status) and the stage of the disease (tumor size and node status). Your oncology team will recommend a treatment plan based on what is known about medullary breast cancer in general and tailored to your specific disease.
We know that it can be stressful to receive a diagnosis of breast cancer, and learning that you have a rare form of the disease can add to your anxiety. We hope it will be reassuring to know that our team at the Center for Rare Breast Tumors is dedicated to latest research and treatment of medullary breast cancer, and is here to support patients and their families through diagnosis, treatment, and survivorship.