Radiopathologic Characteristics of Invasive Mammary Carcinoma With Medullary Features: A Correlative Study.

Area of Science:

• Radiology
• Oncology
• Pathology

Background:

• Invasive mammary carcinoma with medullary features is an uncommon breast cancer subtype.
• Despite high-grade histology, it has a favorable prognosis.
• Accurate radiopathologic correlation is vital for diagnosis and treatment, as imaging can mimic benign findings.

Purpose of the Study:

• To correlate the radiologic and histopathologic characteristics of invasive mammary carcinoma with medullary features.
• To enhance diagnostic precision and guide patient treatment by understanding its radiopathologic profile.

Main Methods:

• A retrospective observational study reviewed 45 cases of histologically confirmed medullary carcinoma and triple-negative basal-like carcinoma (2020-2025).
• Preoperative mammographic and ultrasound features were compared with histopathological findings.
• Descriptive statistics were used to summarize feature prevalence.

Main Results:

• Mammography revealed masses in 90.9% of cases, often with circumscribed margins (53.3%). Calcifications were rare (10%).
• Ultrasound showed hypoechoic masses (83%), irregular shapes (74%), microlobulated margins (51.4%), and posterior acoustic enhancement (91%).
• Histopathology confirmed syncytial growth (93%), high nuclear grade (86%), absence of glandular elements (97.8%), and prominent lymphoplasmacytic infiltrates (100%). All cases were triple-negative.

Conclusions:

• Medullary carcinoma can exhibit imaging features similar to benign lesions, such as circumscribed morphology and posterior acoustic enhancement.
• Imaging alone cannot definitively differentiate medullary carcinoma from other breast lesions.
• Biopsy and histopathological confirmation are essential for accurate diagnosis.