Medullary Carcinoma

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Overview

Medullary Carcinoma is a rare subtype of breast cancer characterized by its histological appearance. It falls under the broader category of carcinomas, which are cancers arising from epithelial cells. Medullary carcinoma is distinct due to its soft, fleshy consistency and well-defined borders, often making it more easily distinguishable from other types of breast cancer.

Histological Classification

• Carcinoma: This classification indicates that the cancer originates from epithelial cells, specifically those lining the ducts of the breast.

Location

• Breast Ducts: Medullary carcinoma typically starts in the ducts of the breast, which are the channels that carry milk from the lobules, where milk is produced, to the nipple.

Symptoms

The symptoms of medullary carcinoma may be similar to those of other types of breast cancer, including:

• A lump or mass in the breast that is often soft and easily movable
• Swelling or thickening of the breast
• Changes in the size or shape of the breast
• Dimpling or puckering of the skin
• Nipple discharge that is not breast milk
• In some cases, pain or tenderness in the breast

Treatments and Cures

Treatment options for medullary carcinoma generally align with those for other types of breast cancer and may include:

1. Surgery:

   • Lumpectomy: Removal of the tumor and some surrounding tissue.
   • Mastectomy: Removal of one or both breasts, partially or completely.

2. Radiation Therapy:

   • Often used after surgery to eliminate remaining cancer cells.

3. Chemotherapy:

   • Utilizes drugs to destroy cancer cells, often used before surgery to shrink tumors or after surgery to eliminate remaining cancer cells.

4. Hormone Therapy:

   • May be used if the cancer is hormone receptor-positive, though medullary carcinoma is often triple-negative (lacking estrogen, progesterone, and HER2 receptors).

5. Targeted Therapy:

   • While not always applicable to medullary carcinoma, therapies targeting specific genetic mutations may be evaluated.

Side Effects

• Surgery: Pain, swelling, change in breast shape, risk of infection.
• Radiation Therapy: Skin irritation, fatigue, swelling, changes in skin texture.
• Chemotherapy: Nausea, vomiting, hair loss, fatigue, increased risk of infection.
• Hormone Therapy: Hot flashes, mood swings, weight gain, risk of blood clots.
• Targeted Therapy: Varies by drug but can include diarrhea, liver problems, and fatigue.

Experimental Treatments

Research into treatments for medullary carcinoma and other triple-negative breast cancers is ongoing:

• Immunotherapy:

  • Utilizes the body's immune system to fight cancer. Pembrolizumab and atezolizumab are examples being explored in clinical trials.

• PARP Inhibitors:

  • Target DNA repair pathways in cancer cells, potentially beneficial for patients with BRCA mutations. Olaparib is a drug in this category.

• Clinical Trials:

  • Participation in trials provides access to cutting-edge treatments. These might include novel drug combinations or treatment protocols.

Modern Developments

• Immunotherapy: Gained traction in cancer treatment around 2015 and continues to be a significant area of research.
• PARP Inhibitors: Approved by the FDA for certain breast cancers in 2014, with ongoing research for broader applications.

Conclusion

Medullary carcinoma, while rare, is a distinct form of breast cancer with a comprehensive treatment approach. Traditional treatments like surgery, radiation, and chemotherapy remain foundational, while modern advances in targeted therapies and immunotherapy offer hope for improving outcomes. Patients should consult with their healthcare provider to understand the best treatment strategy, considering the latest developments and clinical trials.