Medullary breast cancer?

Hi ladies, I had medullary bc three and a half years ago. I find it quite confusing as even though I heard that it is aggressive I also read that it doesn't tend to spread. I did lumpectomy - I had no node involvement- then 30 rads. I was er+ so I'm on tamoxifen now. Also had periods shut down for two years with zoladex. There seems to be very little information on it.

Hugs

Mags 

My 2005 tumor was medullary. I also was told they are aggressive (grow really, really fast) but tend not to travel. My 2007 tumor in my other breast was IDC, so it definitely hadn't traveled from my 2005 tumor. My onc called it a "second primary," in that it wasn't related to my earlier tumor at all! I think medullary's are always triple-neg, and my IDC tumor was triple-neg, too.

I had mastectomies both times, so no rads. But I had chemo both times. (AC/Taxol in 2005 and carboplatin/taxol in 2007) I'm hoping I'm all done with BC since I'm now all out of breast tissue! LOL

--CindyMN

I was diagnosed with atypical medullary (had almost all of the qualifications for pure medullary but not quite) three years ago. Stage one 9mm tumor.I had a mas with tram recon. Had 4 A/C and still cancer free! Medullary is rare and is alomst always triple neg and a grade three tumor. It has a large layer of white cells that surround it and some theories say this keeps it from spreading as fast.

Hello

I was also diagnosed with an atypical medullary in Dec 03, stage IIA ,no nodes ,no vascular invasion ,2.8 cm, triple negative, no multi focal, I didn't meet the criteria for a medullary. I did 4 AC and 4 Taxol and 33 rads. Over four years out and doing great. I don't post alot but had to chime in on this one.

Patty

http://www.google.com/search?hl=en&q=medullary+breast+cancer&btnG=Google+Search

There is a lot of information on Medullary, Atypical Medullary and "similar to" Medullary breast cancer.

If I were you I would get a copy of your surgical report and your path report, sit down for about three hours and read it and compare it to the research here on Google. You CAN learn what these big words mean even if you look 100 of them up in a dictionary as you are reading them.

Don't underestimate your ability to LEARN! I did it, you can do it too. Pretend you have to interpret your path report to someone else.

Pretend you are a biology student learning about Medullary breast cancer so you can teach it to others.

YOU CAN LEARN EVEN IF YOU HAVE TO READ AND LOOK UP THE DEFINITIONS OF EVERY OTHER WORD, LIKE I DID WITH MY PATH REPORT!

You will feel better knowing MORE....at least I know I did. I still pull my path report out and study it occasionally even after 2.5 years of my diagnosis. I have triple negative breast cancer, poorly differentiated with some Medullary features. 

Yes, welcome! I said I have BC, but hopefully I can really say "I HAD BD! since i went thru treatment...

count me in! I had a 2.5 cm atypical medullary cancer lumpectomy in July, 2006. 4 AC + 15 rads (double dose), finished 1/07.  Medullary is named for its appearance under the microscope, looks like brain tissue, big source of jokes for my husband & me (where exactly my brains are located....)

best,

amy

weebles wobble but we don't fall down.

Yes I was moved here by the AF cause of cancer so I could be with my family! I like S A to ! No need to thank me ma'am just doing my job! I think the Marines and Army deserve more of a thanks! I do appreciate it though!

The differance between typical and atypical medullary comes in the path report. The college of american pathologist came up with a group of defining factors for medullay bc. The tumor has to meet all these factors for it to be pure medullary. If it only meets some it is called atypical medullary. Most of the time they are treated the same as regular breast cancer. True medullary bc usually does not spread as fast (even though they are almost always grade 3 tumors) as other breast cancers and if caught early have a cure rate of almost 98%. This is due they think to the wbc layer that surrounds it. It holds it in longer. Get your path report. It should tell all of this. Also google medullary. You can find the factors for diagnosis pure medullary verses atypical. I work in a hospital lab and our pathologist (Md who reads and diagnosis the tumor) confirmed all of this for me when I was diagnosed. Mine had a dense wbc layer surrounding it and although it did not meet all factors and was diagnosed and atypical medullary, I am counting on those little wbc cells and that they kept mine from spreading.. 

Was diagnosed with medullary bc in Sept. 1992. Nodes were all clear.  Had a modified radical mastectomy and that's it.  I'll be 51 in June.

I am glad I came across this post.

My 1st pathology report was sent off for a 2nd opinion because of this very reason, in 2003.

Diagnosis is an IDC Grade 3 ,

Measures 2.7 cmX 1.8 cm Tumor Extends within 0.5mm of inked resection.

Sentinel lymph node negative for  carcinoma,

Tissue from left axilla-Metastatic Adenocarcinoma in 1 of 6 lymph nodes measuring 1.4 x 1.0 cm

Comment from my 1st pathology report:

This tumor has features of medullary carcinoma which would be expected to have a better prognosis then a high grade infiltrating ductal carcinoma. However, this tends to be a rather subjective diagnosis and considering the significant degree of prognostic implications between these 2 lesions, it will be forwarded to Kelowna for further review.

2nd Path report comment:

 (very lengthy & detailed, I have shortened the comments).

I agree with you that the tumor shows some features suggesting a medullary carcinoma (cynctial growth, high grade nuclei with brisk mitotic rate).However the diagnostic features of meduallary carcinoma are not fulfilled by this tumor. 

Specifically, there is too much irregularity and infiltration at the tumor margin,(which should be smooth and rounded in a medullary ca) and there is not enough lymphoplasmacytic infiltrate(which should be diffusly present throughout the lesion, but if not, at least completely around the perimeter of the tumor).

This could be an "atypical medullary carcinoma" or an infiltrating ducatal carcinoma with medullary features, neither of these 2 designations is helpful clinically , tumors such as this should be considered a high grade infiltrating ductal carcinoma Nos.

A.Sentinel node - One lymph node negative for metastatic carcinoma

B. Remaining axillary lymph nodes:

i.One of five positive for metastatic carcinoma measures 1.4 cm

ii.Another one of the five nodes shows a rare atypical subcapsular cells. Suspicious for micrometastasis(please see above).

Seems like the 2 types can be easily confused and or can even have cross over charactertistics in 1 tumor. Either way, I feel my treatment worked, and I generally feel great, with the exception of this awful puffiness, and argggg the post menopausal,post chemo weight gain ( 30ish lbs).

Hugss to all

Barb

Hi Annie,

As far as I know, my breast tumor and the lymph node had the same "type" of cancer. I think the cells in my lymph node were looking like  cells that have "bought a passport to travel through my body". so chemo was not delayed, and started even though my margins were not clear.

I do know that being 41, pre menopausal and ER negative dictated my chemo regime to be FEC( Fluorouracil, Epirubicin( sister drug to Adriamicyn) & Cytoxan. The Neupogen was to keep my WBC(actually the Neutrophils) up so that I could stay on target, and not miss or delay any treatments.

I also had radiation, and after rads, that was it for me since I was a triple neg. No after meds, except Calcium & Vit D.

From what I understood when I was diagnosed, if you are offered to take part in a clinical trial, do it. Apparently those patients in clinical trials are followed more closely after all treatment. It's not a biased follow up, but rather for scientific data to include into the trial results for a year, 2 years, even 10 years later.

Where are you in your course of treatment? Some of my treatment might be different as I am in B.C. Canada.

Hugs

Barb

I am Medullary, and at UCLA, they said it was named that because it looks like brain Medula tissue.  Of course, it has its own characteristics too.  Almost always aggressive, but more stationary.  That is funny, huh?  Oh well, I am coming up on 10 years and since I am also a TriNeg, I hope this one is history.  But who knows what else lies in store?

Barb, mine was 7mm, so I just had a lumpectomy and rads.  Now, I hear, 10 years later, they always do chemo for TriNegs.  Back then, no one seemed to know much about TriNegs.

Hugs, Shirlann