Abstract |
Medullary carcinomas have a better prognosis than other grade 3 mammary carcinomas, but they typically show basal-like biological features, which are associated with a poor prognosis. In this study we examined the associations and prognostic relevance of medullary histological features in a series of 165 invasive carcinomas with a basal-like phenotype: triple-negative (oestrogen receptor, progesterone receptor, HER2) and expressing at least one basal marker (CK5/6, CK14, CK17 or EGFR). The following histological features were associated with each other: prominent inflammation, anastomosing sheets, absence of fibrosis, absence of infiltrative margin and absence of gland formation. Prominent inflammation and anastomosing sheets in at least 30% of the tumour were associated with a better prognosis on univariate analysis. The combination of these two features (a simplified definition of medullary-like type) was present in 17% of tumours and was an independent prognostic factor on multivariate analysis. This simplified definition had good inter-observer reproducibility (κ=0.61) and is worthy of more detailed assessment in an unselected group of mammary carcinomas. A fibrotic focus was present in 36% of carcinomas. Only 3% of tumours with a fibrotic focus had features of medullary-like carcinomas. Fibrotic focus of greater than 30% of the tumour was associated with a poor prognosis. This study emphasizes the heterogeneity of morphology and behaviour of triple-negative basal-like carcinomas.
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Authors | Felicia Marginean, Emad A Rakha, Bernard C Ho, Ian O Ellis, Andrew H S Lee |
Journal | Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
(Mod Pathol)
Vol. 23
Issue 10
Pg. 1357-63
(Oct 2010)
ISSN: 1530-0285 [Electronic] United States |
PMID | 20581807
(Publication Type: Journal Article)
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Chemical References |
- Biomarkers, Tumor
- Keratin-14
- Keratin-17
- Keratin-5
- Keratin-6
- Receptors, Estrogen
- Receptors, Progesterone
- ErbB Receptors
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Topics |
- Aged
- Biomarkers, Tumor
(analysis)
- Breast Neoplasms
(genetics, mortality, pathology)
- Carcinoma, Medullary
(genetics, mortality, pathology)
- ErbB Receptors
(biosynthesis)
- Female
- Genes, erbB-2
- Humans
- Immunophenotyping
- Kaplan-Meier Estimate
- Keratin-14
(biosynthesis)
- Keratin-17
(biosynthesis)
- Keratin-5
(biosynthesis)
- Keratin-6
(biosynthesis)
- Middle Aged
- Prognosis
- Receptors, Estrogen
(biosynthesis, genetics)
- Receptors, Progesterone
(biosynthesis, genetics)
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