Does anyone else have medullary features?

MsBliss

My tumor had medullary features and I was wondering if anyone has been told this.  It may not be of any meaning or consequence but I haven't met anyone else who has been told this.  Anyone?

Morgan513

I'm medullary.  My DX is T2, N0, M0.  Stage 2a.  I had lumpectomy, TCx4, and radiation.  I'm told that medullary is a good thing.

 How are you?

Lorrie

Meece

My cancer pathology report stated the findings were suggestive of medullary carcinoma.  I don't exactly know what that means.  But I made it successfully through it.  I was also a triple negative, like Lorrie.  I thought I was out of this mode, but a recent mamogram, and an upcoming biopsy has this on my mind a lot right now.  I wish the best for you girls.

MsBliss

Hi Morgan and Meece too!

My pathology stated my tumor had medullary features, but each pathology opinion varied slightly.  One said it had a dense rim of lymphocytes and lymphocytes in the tumor, another said there was microscopic invasion at the periphery and minimal lymphocytes.  But it was triple negative, lobulated and about 1.3 cm.  I had negative nodes and lv invasion, but a very high growth rate.  The prescription was TC x4 but I could not take chemotherapy due to having inflammatory bowel disease and an enlarged heart.  I am only 6 months out now and very nervous.  My tumor did not show up on a mammogram--even with a marker over the bump, it was completely invisible.  The radiologist said it was only 6 months or less than a year old--it was growing so fast.

What type of chemo did you have?  What other features and characteristics does your pathology tell you?  We are not very commonly seen.

Meece,  when did you have your cancer and what did your mammogram show?

MsBliss

When did you go through all this?  Did you have chemo?  Medullary and some triple negatives don't show on mammograms all the time....they don't grow slow enough to have calcifications and that is usually how they show on mammograms.

When is your biopsy?  Remember, it could be benign.  I just had a second biopsy, it was benign.

Meece

I found my tumor by self exam, but when I found it, it was visible with the eye!  It was an aggressive fast growing tumor.  I mean, one day it was there, and one day it wasn't! (Visibly that it)  I went to my primary care physician and she said she wasn't to worried, since it seemed to be floating like a cyst.  I had a mammogram and ultrasound, and the radiologist told me right there, it wasn't good.  I do not know if it showed up on the mammogram or not, that day in my life was one of many blurs I experienced.  I then had a needle biopsy which the surgeon had difficulty getting because the tumor was very hard.  I was scheduled to have the lump removed no matter what.  Then the night before the surgeon called and said he needed to talk to me before the surgery.  That was to give me the option of lumpectomy or mastectomy.

I chose the lumpectomy, and went through A/C x 4 and taxol x 4, then six weeks of daily radiation.  I finished radiation 5 years ago this month.   

My biopsy is yet to be scheduled due to the Holiday weekend last week, and a 130 mile distance between my oncologist and I, and a hard nosed employer who has yet to approve a two hour time off presented 8 days ago!  You think stress is good for this?

MsBliss

Hi Meece--oh yeah, stress is candy coating on this wonderful nugget! 

My tumor seemed to be movable, and visible too.  It was at 12 oclock right side and very high up on the chest.  I am lucky it didn't spread to the skin.  It was lobulated and well defined.

The fact that your tumor was hard makes me wonder.  My tumor was firm.  Hard tumors in the breast are usually that way because of the immune response compressing the mass.  I wonder if you had the true medullary form. 

It is unlikely that you have a recurrence of tnbc.  More likely a benign issue.  Five years passed and tnbc rarely recurs after 5 years.  Also, if you had done CMF for chemo, it would be more likely to be an estrogen positive growth--but you did AC which is not associated with this pattern.

Please be pushy about getting this biopsy done sooner.

For whatever it's worth, one onc I saw said if my tumor was true medullary that chemo was not a mandate, and neither was radiation.  But I was reminded that my tumor was not true medullary so I should treat it like IDC.  When I couldn't do chemo, I though, why do radiation either?  Radiation causes problems too.  I am still mulling it over. 

Morgan513

OMG!  My GP told me not to worry either when I went to see her after I found the lump.  It was movable and hard like a cyst! 

 Medullary supposedly has a good prognosis.  It looks scary on the pathology report but doesn't act that way. 

I did TCx4, lumpectomy and radiation.  I'm a year and half out and doing great!  I went for my check up today and all is well!

 Lorrie

MsBliss

Yes, medullary is favorable, but not unless it is true medullary, according to the "hard noses".  Years ago, many people with tumors that had some or minor medullary features were being lumped in with the true medullary group and causing the bell curve to look unfavorable.  So, pathologists came up with the Ridolfi definition for tm which reduced it to five features.  Without all five, it was just regular IDC.  Yet I have discussed the issues with researchers who tell me that certain medullary features can grant favorability, and the Ridolfi definition removes these favorable tumors from the group too easily.  Features like a lot of lymphocytes and microscopic circumscription gave favorable prognosis; while other medullary features like pushing borders or multiple nucleoi don't necessarilly portend favorable status.  It depends on the actual features involved and the whole picture.  There is a lot of intra observer debate with this.  That is why I tried to find out what the truth was with my tumor.  I had to, because chemo was not an open option for me.