Comparative analysis of ultrasonographic and appearances of typical and atypical breast medullary carcinoma

Objective To investigate the relationship between the sonographic and histologic appearances of breast medullary carcinoma, and to determine the value of sonography in the differentiation of typical and atypical breast medullary carcinoma. Methods We retrospectively reviewed ultrasonographic appearances of 19 cases of breast medullary carcinoma which were confirmed by pathology. Results Eight of 19 medullary carcinomas were classified as typical and 11 were atypical. On sonography,a smooth outline was visualized in 6 of the 8 typical medullary carcinomas but in none of 11 atypical carcinomas. A jagged margin was sonographically visualized in 10 of 11 atypical carcinomas, and a focal irregularity in the margin was visualized in 1 of the 11 atypical carcinomas. Four of the typical medullary carcinomas had posterior enhancement, and 8 of the atypical medullary carcinomas showed retrotumoral shadowing. The difference of tumor margin regularity between typical and atypical medullary carcinomas was statistically significant. Conclusions Treatment and prognosis of typical and atypical medullary carcinomas are different. Ultrasonography is useful in the differential diagnosis of typical and atypical medullary carcinomas.