Question: My initial diagnosis was medullary carcinoma which my doctor told me was a “good type” of cancer. My friend referred me to a multi-disciplinary clinic and there they told me I did not have medullary carcinoma but a high grade invasive ductal carcinoma. Needless to say I am confused–how can one person say I have a “good” cancer and another say the opposite?

Answer:  Medullary carcinoma is a very rare type of breast cancer that is in a category called “favorable prognosis” carcinomas.  Besides medullary carcinoma, this group includes tubular carcinoma, mucinous carcinoma, invasive cribriform carcinoma, and others.  The criteria are very strict for making a diagnosis of medullary carcinoma because if all the criteria are not met, the cancer is then a Nottingham grade III invasive carcinoma (high grade). Unfortunately, many pathologists don’t see enough of these rare tumors so it was wise of you to get a second opinion so you can get the appropriate treatment for your cancer.