Medullary carcinomas make up less than 5% of all breast carcinomas. They seen in younger age group (usually under age 50). It is more common in Japanese women and in carriers of BRCA1 mutations. Grossly, they are usually bulky tumors, often reaching 5-6 cm in size. The tumors are soft, well-circumscribed, and have smooth periphery. The cut surface often bulges above the surrounding tissue. Areas of hemorrhage and necrosis are quite common and may lead to cystic degeneration (as seen here). An intact medullary carcinoma with a firm, discrete appearance may be mistaken grossly for a fibroadenoma, however, it lacks the trabeculation and whorled appearance.