Sonographic findings in a patient with cystic hypersecretory duct carcinoma of the breast

Invasive Cystic Hypersecretory Ductal Carcinoma of Breast: Challenges in Diagnosis and Management

Cystic hypersecretory lesions of the breast are a spectrum of conditions ranging from cystic hypersecretory hyperplasia with atypia and invasive cystic hypersecretory carcinoma (CHC). It is a subtype of ductal carcinoma of the breast. The tumour is very infrequent and hence, extensive literature is limited. This culminates in the fact that it does not feature as part of the WHO classification of breast tumours. However, a good knowledge about its distinct pathological features can avert misdiagnosis and help differentiate CHC from other conditions. Thus far, only 22 cases of invasive CHC have been reported, of which 3 were microinvasive. Only 7 cases of axillary lymph node metastasis have been documented. We report a case of invasive CHC of the breast that was metastatic to the axilla and refractory to neoadjuvant chemotherapy. Our case report aims to add to the literature on the disease, aiming to support large-scale studies in the future in order to elaborate on its clinical and biological characteristics.

lnvasive cystic hypersecretory carcinoma of the breast associated with papillary pattern: a rare and poorly recognised variant of ductal carcinoma of the breast

Cystic hypersecretory pattern is a rare and poorly recognised variant of invasive ductal carcinoma of the breast. Cystic hypersecretory lesions of the breast have a spectrum of morphological features ranging from clearly benign cystic hypersecretory hyperplasia (CHH), CHH with atypia, cystic hypersecretory carcinoma (CHC) to invasive CHC. Until now, no case of invasive CHC has been reported in India, to the best of our knowledge. We report a case of a 57-year-old female with a history of a lump in the inferomedial quadrant of the right breast for three years, gradually increasing in size. A mammography showed a well-defined, lobulated radio-opacity. A modified radical mastectomy was done. Gross examination showed multiple cystic spaces filled with thick gelatinous material and solid areas. On histopathology, cystic hypersecretory variant of invasive ductal breast carcinoma with focal papillary pattern was diagnosed. Cystic hypersecretory ductal carcinoma behaves in a low-grade fashion for many years but has a potential for invasiveness and metastasis, so regular follow-up of such cases is crucial.

Cystic hypersecretory ductal carcinoma of the breast: a rare cause of cystic breast mass

We present the case of a surgically confirmed, invasive, cystic hypersecretory ductal carcinoma (CHDC) of the breast in a 43-year-old woman. The initial sonography showed a complex cyst, which required a core biopsy; however, the diagnosis was delayed as the patient refused to undergo the biopsy and the cyst decreased in size, as seen on follow-up sonography. Excision biopsy was performed, and invasive CHDC was diagnosed after regrowth of the cystic lesion. Meticulous sonographic evaluation of a cystic breast mass is always important, and pathology confirmation must be considered if the lesion shows features suspicious for malignancy, as a CHDC could be the cause of a cystic breast mass.

Cystic hypersecretory carcinoma of the breast with paget disease of the nipple: a diagnostic challenge

A unique case of cystic hypersecretory carcinoma in a 48-year-old woman who presented with a tender, palpable abnormality of the lower outer quadrant of her left breast in 2002 is described. Mammographic and ultrasound examinations showed heterogeneous, dense breast tissue with a focal asymmetric density and an ill-defined heterogenous hypoechoic area with anechoic spaces, respectively, that corresponded to the area of palpable abnormality. Although the imaging findings did not change significantly over 4 years, the patient complained of intermittent, spontaneous serous discharge from the left nipple and persistent induration and tenderness in the same area of the left breast. An ultrasound-guided core-needle biopsy of the lesion was performed at the last visit to rule out a malignant process. A left simple mastectomy showed a large multicystic lesion occupying most of the lower quadrants by a cystic hypersecretory carcinoma and Paget disease of the nipple.

Large cystic infiltrating ductal carcinoma in male breast

Cystic infiltrating ductal carcinoma is a very rare entity that, to the best of our knowledge, has not yet been reported in males. We report the sonographic and CT findings of a large cystic infiltrating ductal carcinoma in a 51-year-old man. Cystic infiltrating ductal carcinoma is a very rare entity that, to the best of our knowledge, has not yet been reported in males. We report the sonographic and CT findings of a large cystic infiltrating ductal carcinoma in a 51-year-old man.