What to know about cribriform breast cancer

Cribriform breast cancer is a rare type of breast cancer that often develops alongside another form of the disease. It is typically a low grade, slow-growing cancer that has a better outlook than most other types.
Many invasive breast cancers have parts of the tumor that are cribriform, which refers to the small holes that appear on the tumor.
In this article, we explain the grading and types of cribriform breast cancer and ways of diagnosing the disease.
Overview
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This type of cancer involves breast cancer cells that feature a pattern of holes. According to BreastCancer.org, the appearance of these holes closely resembles those in Swiss cheese.
cancer
BreastCancer.org
Cribriform cancer can also include features from other types of breast cancer.
A person may have more than one type of cancer in a tumor. A doctor may also diagnose invasive mammary carcinoma of no special type, meaning the cancer cells do not resemble any specific type.
carcinoma
Several different types of cells can grow in breast cancers, including:
tubular
mucinous cribriform
micropapillary
Cribriform cells are among the least common.
Learn more about breast cancer.
breast cancer
Grading
Grading of a tumor means that a doctor examines the cancer cells and describes them as grade X, 1, 2, 3, or 4. Grading is important, as it reveals how different the cancerous cells are in comparison to healthy breast cells.
means
The higher the grade, the faster the cancer cells usually grow. The grading of breast cancer is as follows:
Grade X: Doctors cannot assess the tumor’s grade.
Grade 1: The tumor cells are slow-growing and closely resemble those of typical breast cells.
Grade 2: The tumor cells are moderately different from healthy cells.
Grade 3: The tumor cells are highly atypical and grow quickly.
Grade 4: The tumor cells are high grade, and their appearance is the most atypical.
As well as the grading, a doctor will also need to decide the staging of the cancer when considering a person’s outlook and suitable treatments.
Staging
Staging defines the extent of the cancer, including how far it has spread and the tumor size. There are several main staging systems. The anatomic stage stems from the size and the spread of cancer according to the “TNM” system. The prognostic stage is for people who have surgery as their initial treatment.
Staging for cribriform breast cancer uses the TNM staging system, including numbers indicating size and spreading:
uses
primary tumor size (T)
regional lymph node status (N)
distant metastasis or spreading to other organs (M)
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 tissue. Early detection and treatment at this stage usually have an excellent outlook.
Stage 1: A tumor at this stage measures 2 centimeters (cm) or less in diameter and has not spread beyond the breast.
Stage 2: Doctors define a stage 2 tumor in one of several ways. This tumor type will be: smaller than 2 cm and have spread to one to three lymph nodes under the armbetween 2 and 5 cm with or without spreading to lymph nodeslarger than 5 cm without spreading to lymph nodes
smaller than 2 cm and have spread to one to three lymph nodes under the arm
between 2 and 5 cm with or without spreading to lymph nodes
larger than 5 cm without spreading to lymph nodes
Stage 3: As with stage 2, several characteristics constitute a stage 3 tumor: The tumor is any size in diameter and has spread to more than three lymph nodes or into the chest wall.The tumor is larger than 5 cm, with spread to one to three lymph nodes.
The tumor is any size in diameter and has spread to more than three lymph nodes or into the chest wall.
The tumor is larger than 5 cm, with spread to one to three lymph nodes.
Stage 4: At its most severe stage, cancer will have spread outside the breast to other organs. This is metastasis.
metastasis
The stage of cancer can help doctors decide on the most appropriate treatments. As a general rule, the lower the stage of breast cancer, the more likely that treatment will be effective.
Learn more about breast cancer staging and size.
breast cancer staging and size
Treatment
Cribriform breast cancer metastasizes or spreads to lymph nodes under the arm less frequently than other forms. As a result, the outlook for cribriform breast cancer is usually positive.
breast cancer metastasizes
usually
Hormones often influence cribriform breast cancer, especially estrogen and progesterone.
estrogen
progesterone
However, there are currently no standard treatment guidelines specific to cribriform breast cancer. 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 of the breast tissue. This way, the surgeon can be sure that they have extracted all cancerous cells from the breast.
lumpectomy or mastectomy
Chemotherapy: Chemotherapy involves administering drugs to kill rapidly multiplying cancer cells.
Chemotherapy
Radiation: Radiation involves exposing the tumor to high energy radiation that targets and kills cancerous cells.
Radiation
Hormone therapy: This involves drugs that inhibit the action of hormones, such as estrogen and progesterone, which contribute to breast cancer. Tamoxifen is a common hormone therapy drug that prevents estrogen from binding to cancer cells.
Each of these treatments has side effects that range from mild to severe. People need to discuss all treatment options and their risks with their doctors.
Learn more about treating breast cancer.
treating breast cancer
Diagnosis
A doctor will usually order a mammogram, which is an X-ray image of the breast. They may also request an ultrasound scan, which uses sound waves to identify tumors or masses in the breast.
usually
mammogram
ultrasound scan
Cribriform breast cancer does not typically cause symptoms, and cancerous lesions are not always easily visible in a mammogram. If the diagnosis is unclear, the doctor may request further imaging studies, such as an MRI scan. These scans produce more precise images to aid in diagnosis.
MRI scan
When a doctor identifies a potentially cancerous lesion in the breast, they will recommend a biopsy. This procedure involves extracting cells from the breast with a needle and sending them to a lab for investigation.
biopsy
A pathologist then examines the sample under a microscope to identify different types of cancerous cells.
A tumor with cribriform cells will show under a microscope with its characteristic holed appearance.
On receiving the results, the doctor will grade and stage the tumor. They can then make recommendations on the best course of treatment.
Outlook
According to the American Cancer Society, cribriform breast cancer is a less common type of cancer than a typical invasive ductal carcinoma, which affects the milk ducts.
less common type
Cribriform breast cancer does not usually metastasize or spread to lymph nodes under the arm. As a result, the outlook for cribriform breast cancer is usually favorable.
According to an older 2015 study, the 10-year overall survival rate for people with this type is 90% to 100%.
an older 2015 study
This means that 90% to 100% of those with this form of breast cancer will survive for at least 10 years after diagnosis.
Frequently asked questions
Below are answers to common questions about cribriform breast cancer.
Cribiform refers to the appearance of the tumor, which resembles Swiss cheese.
resembles
The most severe form of breast cancer is triple-negative breast cancer. Targeted treatment includes immunotherapy.
most severe
Out of all breast cancers, inflammatory breast cancer and triple-negative breast cancer have the highest rates of recurrence.
inflammatory breast cancer and triple-negative breast
Summary
Cribriform breast cancer is a rare type of breast cancer in which the tumor contains small holes. It is usually a low grade, slow-growing cancer that has a better outlook than most other types of breast cancer.
Treatment involves surgery, radiation, and hormone therapy medications such as Tamoxifen. The outlook is usually favorable, as the cancer does not usually metastasize or spread to lymph nodes under the arm.