Challenges in the Diagnosis of Invasive Cribriform Cancer of the Breast: A Case Report and Literature Review

Invasive cribriform cancer of the breast (ICC) is a rare type of breast cancer characterized by its unique cribriform cell pattern. It is frequently seen in menopausal women, presenting with bloody nipple discharge or breast mass as an incidental finding. It is classified as a good prognosis tumor; however, it imposes diagnosis challenges due to its shared similarities with other breast cancers and coexistence with various histological subtypes.

A 62-year-old lady presented with a 2-month history of breast discharge with a palpable mass. An imaging study revealed a BI-RADS 4 category (according to imaging reporting and data system), implying a definitive probability of malignant pathology. A core needle cytology suggested atypical hyperplasia or invasive malignancy; an excisional biopsy and immunohistochemistry study confirmed ICC diagnosis.

The integration of histopathological examination with immunohistochemistry unveiled ICC diagnosis and excluded other differential diagnoses. Several challenges can be associated with ICC diagnosis, as it may present with subtle or atypical imaging criteria or even tend to regress, which is why radiologists should experience a high index of suspicion.

This case reinforces the diagnostic complexities encountered during breast cancer management, emphasizing the need for a multidisciplinary approach and judicious use of diagnostic modalities to improve diagnosis precision and allow a tailored treatment plan for better patient prognosis and outcomes.