{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:20:36Z","timestamp":1787847636401,"version":"build-2784847793"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Medullary breast carcinomas (MBCs) are distinguished by circumscribed, high-grade morphology with dense chronic inflammation; they are associated with the basal phenotype but have a relatively good prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This study aimed to review the clinicopathological features of MBCs diagnosed at the Department of Pathology, Singapore General Hospital and correlate them with immunohistochemical expression of hormonal markers and c-erbB-2, the basal markers p53, cytokeratin (CK) 14, epidermal growth factor receptor (EGFR) and 34BE12, and the follow-up outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Using Ridolfi\u2019s criteria for histologic reviews, 62 patients previously diagnosed as having \u2018typical MBC\u2019 (n = 26), \u2018atypical MBC\u2019 (n = 32) and \u2018invasive carcinoma with focal medullary-like features\u2019 (n = 4) were re-classified as follows: \u2018typical MBC\u2019 (n = 6; 9.7%), \u2018atypical MBC\u2019 (n = 46; 74.2%), and \u2018non-medullary infiltrating carcinoma\u2019 (n = 10; 16.1%). Clinicopathological parameters, including ethnicity, age, tumour size and concurrent ductal carcinoma\n                      <jats:italic toggle=\"yes\">in situ<\/jats:italic>\n                      (DCIS), showed no statistically significant correlation with review diagnoses and immunohistochemical findings. Presence of lymphovascular invasion and nodal stage were significantly correlated with recurrence and breast cancer-related deaths, respectively. ER negativity was significantly correlated with triple positivity for basal markers CK14, EGFR and 34BE12, which comprised patients who showed a significantly decreased disease-free survival rate within a 10\u201315-year follow-up period.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Lymphovascular invasion and high nodal stage as well as triple negativity among typical and atypical MBCs that have basal-like phenotype represent a portion of invasive carcinomas with medullary features that may have poor outcomes in this otherwise relatively good prognostic group.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.11622\/smedj.2021031","type":"journal-article","created":{"date-parts":[[2021,4,18]],"date-time":"2021-04-18T21:39:21Z","timestamp":1618781961000},"page":"394-401","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Medullary breast carcinoma: a pathogenic review and immunohistochemical study using tissue microarray"],"prefix":"10.4103","volume":"63","author":[{"given":"Ming","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Pathology, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Richelia","family":"Jara-Lazaro","sequence":"additional","affiliation":[{"name":"Department of Pathology, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Poh Yian","family":"Cheok","sequence":"additional","affiliation":[{"name":"Department of Pathology, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aye Aye","family":"Thike","sequence":"additional","affiliation":[{"name":"Department of Pathology, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,4,16]]},"reference":[{"key":"B1-20240829","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1002\/1097-0142(194907)2:4<635::AID-CNCR2820020411>3.0.CO;2-Q","article-title":"The relatively favorable prognosis of medullary carcinoma of the breast","volume":"2","author":"Moore","year":"1949","journal-title":"Cancer"},{"key":"B2-20240829","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1002\/1097-0142(197710)40:4<1365::AID-CNCR2820400402>3.0.CO;2-N","article-title":"Medullary carcinoma of the breast:a clinicopathologic study with 10 year follow-up","volume":"40","author":"Ridolfi","year":"1977","journal-title":"Cancer"},{"key":"B3-20240829","first-page":"28","article-title":"Pathology and Genetics:World Health Organization Classification of Tumours. Tumours of the Breast and Female Genital Organs","volume":"2003","author":"Tavassoli","journal-title":"Lyon:IARC Press"},{"key":"B4-20240829","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1016\/S0046-8177(88)80290-9","article-title":"Medullary carcinoma of the breast:a clinicopathologic study with appraisal of current diagnostic criteria","volume":"19","author":"Wargotz","year":"1998","journal-title":"Hum Pathol"},{"key":"B5-20240829","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1007\/BF01805979","article-title":"Inter- and intraobserver variability in the histopathological diagnosis of medullary carcinoma of the breast, and its prognostic implications","volume":"14","author":"Pedersen","year":"1989","journal-title":"Breast Cancer Res Treat"},{"key":"B6-20240829","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1002\/jso.2930600205","article-title":"Typical medullary carcinoma of the breast:a clinical and pathological analysis of 52 cases","volume":"60","author":"Reinfuss","year":"1995","journal-title":"J Surg Oncol"},{"key":"B8-20240829","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1093\/jnci\/90.15.1138","article-title":"Multifactorial analysis of differences between sporadic breast cancers and cancers involving BRCA1 and BRCA2 mutations","volume":"20","author":"Lakhani","year":"1998","journal-title":"J Natl Cancer Inst"},{"key":"B9-20240829","first-page":"1588","article-title":"Mutations at BRCA1:the medullary breast carcinoma revisited","volume":"58","author":"Eisinger","year":"1998","journal-title":"Cancer Res"},{"key":"B10-20240829","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1093\/jnci\/91.7.641","article-title":"p53 mutation as a genetic trait of typical medullary breast carcinoma","volume":"91","author":"de","year":"1999","journal-title":"J Natl Cancer Inst"},{"key":"B11-20240829","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1002\/path.1845","article-title":"Typical medullary breast carcinomas have a basal\/myoepithelial phenotype","volume":"207","author":"Jacquemier","year":"2005","journal-title":"J Pathol"},{"key":"B12-20240829","doi-asserted-by":"crossref","first-page":"4636","DOI":"10.1158\/0008-5472.CAN-06-0031","article-title":"Gene expression profiling shows medullary breast cancer is a subgroup of basal breast cancers","volume":"66","author":"Bertucci","year":"2006","journal-title":"Cancer Res"},{"key":"B13-20240829","doi-asserted-by":"crossref","first-page":"R24","DOI":"10.1186\/bcr1666","article-title":"Identification of typical medullary breast carcinoma as a genomic sub-group of basal-like carcinomas, a heterogeneous new molecular entity","volume":"9","author":"Vincent-Salomon","year":"2007","journal-title":"Breast Cancer Res"},{"key":"B14-20240829","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1097\/01.pas.0000213427.84245.92","article-title":"Sporadic invasive breast carcinomas with medullary features display a basal-like phenotype:an immunohistochemical and gene amplification study","volume":"31","author":"Rodr\u00edguez-Pinilla","year":"2007","journal-title":"Am J Surg Pathol"},{"issue":"A","key":"B15-20240829","doi-asserted-by":"crossref","first-page":"1792","DOI":"10.1016\/0959-8049(94)00251-Y","article-title":"Medullary carcinoma of the breast, prognostic importance of characteristic histopathological features evaluated in a multivariate Cox analysis","volume":"30","author":"Pedersen","year":"1994","journal-title":"Eur J Cancer"},{"key":"B16-20240829","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1046\/j.1365-2559.1997.5720795.x","article-title":"Prognostic comparison of three classifications for medullary carcinomas of the breast","volume":"30","author":"Jensen","year":"1997","journal-title":"Histopathology"},{"key":"B17-20240829","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1016\/j.ejca.2009.02.014","article-title":"The prognostic significance of inflammation and medullary histological type in invasive carcinoma of the breast","volume":"45","author":"Rakha","year":"2009","journal-title":"Eur J Cancer"},{"key":"B18-20240829","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1179\/his.2004.27.2.113","article-title":"Initial experience with tissue microarray (TMA) in a surgical pathology laboratory:technical considerations","volume":"27","author":"Tan","year":"2004","journal-title":"J Histotechnol"},{"key":"B19-20240829","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1038\/modpathol.2010.123","article-title":"Histological features of medullary carcinoma and prognosis in triple-negative basal-like carcinomas of the breast","volume":"23","author":"Marginean","year":"2010","journal-title":"Mod Pathol"},{"key":"B20-20240829","first-page":"1005","article-title":"Medullary carcinoma of the breast. A multicenter study of its diagnostic consistency","volume":"117","author":"Rigaud","year":"1993","journal-title":"Arch Pathol Lab Med"},{"key":"B21-20240829","doi-asserted-by":"crossref","first-page":"2310","DOI":"10.1200\/JCO.2002.09.023","article-title":"The pathology of familial breast cancer:predictive value of immunohistochemical markers estrogen receptor, progesterone receptor, HER-2, and p53 in patients with mutations in BRCA1 and BRCA2","volume":"20","author":"Lakhani","year":"2002","journal-title":"J Clin Oncol"},{"key":"B22-20240829","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1038\/modpathol.2009.145","article-title":"Triple negative breast cancer:clinicopathological characteristics and relationship with basal-like breast cancer","volume":"23","author":"Thike","year":"2010","journal-title":"Mod Pathol"},{"key":"B23-20240829","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1097\/PAS.0b013e3181e02f45","article-title":"Triple negative breast cancer:outcome correlation with immunohistochemical detection of basal markers","volume":"34","author":"Thike","year":"2010","journal-title":"Am J Surg Pathol"},{"key":"B24-20240829","doi-asserted-by":"crossref","first-page":"R35","DOI":"10.1186\/bcr2857","article-title":"Mutations in the epidermal growth factor receptor (EGFR) gene in triple negative breast cancer:possible implications for targeted therapy","volume":"13","author":"Teng","year":"2011","journal-title":"Breast Cancer Res"}],"container-title":["Singapore Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.11622\/smedj.2021031","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:25:38Z","timestamp":1787844338000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.11622\/smedj.2021031"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,16]]},"references-count":23,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.11622\/smedj.2021031","relation":{},"ISSN":["0037-5675","2737-5935"],"issn-type":[{"value":"0037-5675","type":"print"},{"value":"2737-5935","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,16]]},"assertion":[{"value":"2019-12-26","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-02-25","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}