Yc. Cheung et al., Sonographic and pathologic findings in typical and atypical medullary carcinomas of the breast, J CLIN ULTR, 28(7), 2000, pp. 325-331
Purpose. We investigated whether there was a relationship between the sonog
raphic and histologic appearances of medullary carcinomas of the breast to
determine whether sonography is helpful in the differentiation of typical a
nd atypical medullary carcinomas.
Methods. We retrospectively reviewed the histologic slides and sonograms of
20 patients who had been diagnosed with medullary carcinoma of the breast.
We then classified the carcinomas as typical or atypical based on strict h
istologic criteria. We also evaluated the relationship between sonographic
findings and the histologic reclassification.
Results. Eight (40%) of the 20 medullary carcinomas were classified as typi
cal, and 12 (60%) were classified as atypical. On sonography, a smooth outl
ine was visualized in 6 (75%) of the 8 typical medullary carcinomas but in
none of the 12 atypical carcinomas. A jagged margin was sonographically vis
ualized in 10 (83%) of the 12 atypical carcinomas, and a focal irregularity
in the margin was visualized in 2 (17%) of the 12 atypical carcinomas. Fou
r of the typical medullary carcinomas had posterior enhancement, and 9 of t
he atypical medullary carcinomas showed retro-tumoral shadowing. The differ
ence in tumor-margin regularity between typical and atypical medullary carc
inomas was found to be statistically significant (p < 0.001) using the 2-ta
iled Fisher's exact test.
Conclusions. To prevent overdiagnosis of medullary carcinoma, a thorough pa
thologic review of the entire tumor is recommended if sonography shows a ja
gged margin or a margin with focal irregularity. (C) 2000 John Wiley & Sons
, Inc.