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Medullary Breast Cancer 

Medullary breast cancer is a rare type of breast cancer that accounts for less than 5% of all breast cancers and is a subtype of invasive breast cancer. The condition starts developing in the milk ducts of the breast and then spreads to the tissues around the duct. Medullary refers to the tumor’s appearance which is soft, fleshy, and looks like the medulla – the soft gray matter in the brain stem. 

Causes of Medullary Breast Cancer 

A host of hormones play a role in the development of other types of breast cancer, however, they do not influence medullary carcinoma. 

According to research studies, medullary carcinoma develops as a result of genetic mutations. Individuals with a mutation in the BRCA1 gene could have an increased risk of developing medullary breast carcinoma, and the condition develops in up to 19% of individuals with the BRCA1 gene mutation. 

Symptoms of Medullary Breast Cancer 

Symptoms of medullary breast cancer include: 

  • Nipple pain 
  • Swelling of the breast or tenderness 
  • Nipple discharge 
  • Presence of a lump that may appear red, warm, and painful 
  • Dimpling or scaling of the breast skin 

Diagnosis of Medullary Breast Cancer 

During the diagnosis of medullary breast cancer, the doctor will do a physical examination which involves feeling for the lumps in the patient’s breast as well as swollen nodes in the underarm area. 

He/she might recommend the following tests for further evaluation: 

  • Mammogram: This is done through an X-ray, which produces internal pictures of the breast. 
  • Ultrasound: This is an imaging test that uses high-frequency sound waves to take internal pictures of the breast tissue. 
  • Fine Needle Biopsy: During this procedure a thin needle is connected to a syringe and inserted into the lump to remove a sample of tissue or fluid from the tumor and sent to the lab for further examination under a microscope. 

Treatment Options for Medullary Breast Cancer 

Early detection and intervention of medullary breast cancer can improve the prognosis and can lead to a more effective treatment option. It is important to note that medullary breast carcinoma is a bit complicated in making an accurate diagnosis since it has similar cells to those of invasive ductal carcinoma (IDC). 

There are a variety of effective treatment options for medullary breast carcinoma whereby the best treatment option varies from person to person depending on several factors which may include: 

  • Stage of the cancer 
  • Lymph node involvement 
  • The type of cell in the tumor 
  • Hormone node involvement 

Mastectomy, which is the removal of the entire breast is an option that is likely to be recommended in the treatment of medullary breast carcinoma. 

Since medullary breast carcinoma is less likely than other types of breast cancers in spreading to the lymph nodes, the doctor may opt for surgery without any additional treatments like chemotherapy or radiation therapy. 

However, some doctors may recommend a combination of surgery and either one or more adjuvant treatments more so if the cancer cells indicate IDC or have spread to the surrounding breast tissue or to the nearby lymph nodes. 

Other systemic therapies for medullary carcinoma include: 

  • Targeted therapy which often uses specialized drugs that target proteins in cancer cells that prevents them from growing. 
  • Chemotherapy uses cytotoxic drugs to kill cancer cells 
  • Radiation therapy which uses high energy X-rays that destroy cancer cells 

 

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