Carcinoma mammario cribriforme invasivo (ICC)

Il carcinoma cribriforme è così  chiamato perché al microscopio ottico si osservano degli spazi vuoti tra le cellule che lo fanno assomigliare ad un setaccio. Spesso il carcinoma cribriforme è associato al carcinoma  duttale in situ (DCIS) (1-4). Presenta un’incidenza del 0.3-4% fra tutte le neoplasie maligne mammarie primarie.

Diagnosi: 

• Palpazione: il ca. cribriforme invasivo (ICC) si apprezza come un piccolo (2,5 cm) nodulo o un’area che sembra più consistente rispetto al resto parenchima mammario. 
• Mammografia 
• USG 
• Biopsia
• Aspirazione con ago sottile (FNA) 

Esame Prognosi: buona a motivo della lenta crescita.

Esame anatomo-patologico: La massa del tumore è solida, di colorito grigio-bianca, dura, acapsulata. Se il tumore ha un pattern invasivo e cribriforme >90% ed è associato a meno del 50% di una componente tubulare, allora dovrebbe essere classificato come un ICC classico. Tuttavia, se il tumore ha un pattern invasivo e un pattern cribriforme, ma è accompagnato dal 10% al 49% di altre componenti morfologiche (escluso il carcinoma tubulare), allora dovrebbe essere classificato come ICC misto. 

Terapia chirurgica in  prima istanza: prevede lumpectomia o mastectomia in base alle dimensioni della neoplasia e se è interessata più di un’area della mammella.

Terapia adiuvante include:

• radioterapia
• terapia ormonale: la maggior parte dei tumori al seno cribriformi sono ER positivi (9).
• chemioterapia
• terapia mirata (target therapy)
• bifosfonati

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