In this article, learn about the grading and types of cribriform breast cancer, as well as how it is diagnosed.
What is cribriform breast cancer?
Cribriform breast cancer is one of the less common forms of breast cancer, and has a generally good outlook in comparison to others.
According to one study, an estimated 0.3 to 3.5 percent of people with breast cancer have cribriform breast cancer.
As well as these cells, cribriform cancer can also include features from other types of breast cancers.
A person can have more than one type of cancerous cells in a particular tumor. A doctor may also diagnose a person with invasive mammary carcinoma of no special type, which means the cancer cells do not resemble any specific cancerous cells.
Different cancer cell types
Several different types of cells grow in breast cancers, including:
According to the American Cancer Society, cribriform breast cancer is a less common type of cancer than a typical invasive ductal carcinoma, and people with this kind of cancer have a much better outlook than, for example, people who have micropapillary breast cancer.
Cribriform breast cancer grading
Grading a tumor means that a doctor will look at the cell types and describe the cancer cells as grade 1, 2, or 3. Grading is important because it tells other doctors how different the cancerous cells are from healthy breast cells.
The higher the grade, the faster the cancer cells usually grow. The grading of breast cancer is:
- Grade 1: The tumor cells are slow-growing and closely resemble those of normal breast cells.
- Grade 2: The tumor cells are moderately different from normal cells.
- Grade 3: The tumor cells are very abnormal and appear to be growing quickly.
As well as the grading, a doctor will also need to take staging into account when considering prognosis and treatments.
Cribriform breast cancer staging
There are four different stages for cribriform breast cancer, which describe different stages of progression.
Staging refers to the extent of the cancer, including how far it has spread and how large the tumor is. Staging for cribriform breast cancer is as follows:
- Stage 0 (carcinoma in situ): At this stage of breast cancer, the cancerous cells have not spread beyond the ducts of the breast into the fatty part of the breast.
- Stage 1: The tumor at this stage is 2 centimeters (cm) or less in diameter and has not spread beyond the breast.
- Stage 2: Tumors at this stage are smaller than 2 cm with spread to 1-3 lymph nodes under the arm, OR between 2 and 5 cm with or without spreading to lymph nodes, OR larger than 5 cm without spreading to lymph nodes.
- Stage 3: The tumor is any size in diameter and has spread to more than 3 lymph nodes or into the chest wall, OR the tumor is larger than 5 cm with spread to 1-3 lymph nodes.
- Stage 4: The cancer has spread outside the breast and to other organs. This is known as metastasis.
The stage of cancer can help doctors make treatment recommendations. As a general rule, the lower the stage, the more treatable the breast cancer.
Treatment for cribriform breast cancer
If the cancerous cells can be removed, surgery may be recommended. This may involve a lumpectomy or mastectomy.
Knowing a woman has cribriform breast cancer impacts on what treatment recommendations a doctor may make.
According to an article published in the journal Oncology Letters, cribriform breast cancer type does not usually metastasize or spread to lymph nodes under the arm. As a result, the prognosis for cribriform breast cancer is often "favorable" or good.
This cancer type is often influenced by hormones, especially estrogen and progesterone, but there are currently no standard treatment protocols specific to cribriform breast cancer. As a result, a doctor will consider the cancer's stage and discuss treatment options.
Examples of the treatments for cribriform breast cancer include:
- Surgical removal: A doctor may recommend a lumpectomy or mastectomy to remove some or all breast tissue and ensure all the cancerous cells are removed.
- Chemotherapy: Chemotherapy helps to kill fast-multiplying cancer cells.
- Radiation: Radiation involves exposing the tumor to high-energy radiation to kill cancerous cells.
- Hormone therapy: These drugs inhibit the action of hormones known to contribute to breast cancer, such as estrogen and progesterone. A typical example is Tamoxifen, which keeps estrogen from binding to cancer cells.
Each of these treatments has side effects that range from mild to severe. A person should discuss all treatment options with their doctor.
A doctor will usually order a mammogram, which is an X-ray image of the breast. A doctor may also order an ultrasound scan, which utilizes sound waves to identify tumors or masses in the breast. Sometimes a doctor may order other imaging studies, such as computed tomography (CT) or magnetic resonance imaging (MRI) scans to get a clearer picture.
Cribriform breast cancer does not typically cause symptoms. The cancerous lesions also are not always easily seen on a mammogram. However, other imaging studies, such as an ultrasound, can help doctors identify a potential cribriform breast cancer.
When a doctor identifies a potentially cancerous lesion in the breast, they will often recommend a biopsy. A pathologist will examine the cells under a microscope to identify different types of cancerous cells. One example of the cancerous cell types is cribriform breast cancer.
When a surgeon performs a biopsy of the breast or removes the tumor entirely, they review the tumor under a microscope. The tumor with cribriform cells will have holes between the cancer cells, resembling Swiss cheese.
The incidence of cribriform breast cancer is between 0.3 and 3.5 percent. This cancer type does not usually metastasize or spread to lymph nodes under the arm. As a result, the prognosis for cribriform breast cancer is usually favorable.