Cribriform breast cancer

Cribriform breast cancer is a rare type of breast cancer.

It’s usually slow growing and low grade. This means generally people with cribriform breast cancer have a good outlook (prognosis) after treatment.

Cribriform breast cancer may be mixed with other types of breast cancer.

If it’s not mixed with another type, it’s called pure cribriform.

Cribriform cancer cells can also be found in a type of early breast cancer called DCIS (ductal carcinoma in situ).

As with most types of breast cancer, the symptoms of cribriform breast cancer include:

• A lump or thickening of the breast tissue
• A change of skin texture, such as puckering or dimpling
• A lump or swelling under the arm
• Changes to the nipple
• Discharge from the nipple
• A change in the size or shape of the breast

However, it’s often found during routine breast screening before there are any symptoms.

Cribriform breast cancer is diagnosed using a range of tests. These may include:

• A mammogram
• An ultrasound scan
• A core biopsy of the breast and sometimes lymph nodes
• A fine needle aspiration (FNA) of the breast and sometimes lymph nodes 

As with all types of breast cancer, the treatments you’re offered will depend on the features of the cribriform breast cancer, such as its:

• Size
• Grade
• Hormone receptor status
• HER2 status

Treatment aims to remove the cancer and reduce the risk of it coming back or spreading to other parts of the body.

Surgery

Surgery is usually the first treatment for cribriform breast cancer.

There are 2 main types of breast surgery:

• Breast-conserving surgery, also known as wide local excision or lumpectomy – removal of the cancer with a margin (border) of normal breast tissue around it
• Mastectomy – removal of all the breast tissue usually including the nipple area

The type of surgery you’re recommended will depend on:

• The area of the breast affected
• The size of the cancer relative to the size of your breast
• Whether more than 1 area in the breast is affected

You may need more surgery if the margin of normal tissue surrounding the cancer that was removed during the first operation is not clear. This is to make sure all the cancer has been removed. In some cases, this second operation will be a mastectomy.

Most women who have a mastectomy will have the option to have breast reconstruction.

Surgery to the lymph nodes

Your treatment team will want to check if any of the lymph nodes (glands) under your arm contain cancer cells. This, along with other information about your breast cancer, helps them decide whether you will benefit from any additional treatment after surgery.

Cribriform breast cancer is less likely to spread to the lymph nodes than most other types of breast cancer. This is particularly the case if the cancer is small or if it’s “pure” cribriform breast cancer.

Other treatments

After surgery, you may need other treatments. These can include:

• Radiotherapy
• Hormone (endocrine) therapy
• Chemotherapy
• Targeted therapy
• Bisphosphonates

These treatments aim to reduce the risk of breast cancer returning in the same breast or spreading somewhere else in the body.

Which treatments are recommended will depend on your individual situation.

Treatments given after surgery are called adjuvant treatments.

Radiotherapy

Radiotherapy uses high energy x-rays to destroy cancer cells.

If you have breast-conserving surgery you’ll usually be offered radiotherapy to the breast.

Radiotherapy is sometimes given to the chest wall after a mastectomy.

Hormone (endocrine) therapy

Some breast cancers use oestrogen in the body to help them grow. These are known as oestrogen receptor positive or ER-positive breast cancers.

Most cribriform breast cancers are ER-positive.

Hormone therapies block or stop the effect of oestrogen on breast cancer cells. Different hormone therapy drugs do this in different ways.

Hormone therapy will only be prescribed if your breast cancer is ER-positive.

Chemotherapy

People with cribriform breast cancer do not usually have chemotherapy.

This is because it’s less common for cribriform breast cancer to spread to the lymph nodes under the arm. And it’s more likely than other types of breast cancer to grow slowly.

Targeted therapy

People with cribriform breast cancer do not usually have targeted therapy.

Targeted therapy is the name given to a group of drugs that block the growth and spread of cancer.

Your treatment team can tell you whether a targeted therapy drug would be suitable for you, based on the features of your cancer.

Bisphosphonates

Bisphosphonates are a group of drugs that can reduce the risk of breast cancer spreading in women who have been through the menopause.

Your treatment team can tell you if bisphosphonates would be suitable for you.

You will continue to be monitored after your hospital-based treatments (such as surgery, chemotherapy or radiotherapy) finish. This is known as follow-up.

It can be difficult to know how your breast or scar should feel. The area around the scar may feel lumpy, numb or sensitive. This means you'll need to get to know how it looks and feels so you know what’s normal for you. This will help you to feel more confident about noticing changes and reporting them early to your GP or breast care nurse.

Having breast cancer in one breast means the risk of developing cancer in the other breast (a new primary breast cancer) is slightly higher than in someone who's never had breast cancer. Therefore it's important to be aware of any new changes to your breasts and to report these as soon as possible.

If you’ve been diagnosed with breast cancer, you might be feeling lonely or isolated. It’s completely natural to have these feelings.

You might find it helps to talk to someone who has been diagnosed with breast cancer. Find out about our Someone Like Me service below.

You can also visit our confidential online forum and talk to other people affected by breast cancer.

You can also speak to our nurses on our free helpline, below.