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Zhao YY, Ge HJ, Yang WT, Shao ZM, Hao S. Secretory breast carcinoma: clinicopathological features and prognosis of 52 patients. Breast Cancer Res Treat 2024; 203:543-551. [PMID: 37897648 DOI: 10.1007/s10549-023-07153-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 09/29/2023] [Indexed: 10/30/2023]
Abstract
PURPOSE Secretory breast carcinoma is a rare histological subtype of invasive breast cancer and considered with an indolent clinical behavior. This study was conducted to analyze the clinicopathological features of patients with secretory breast carcinoma (SBC), explore the outcome, and compare the prognostic difference with invasive ductal breast carcinoma (IDC). METHODS AND MATERIALS: Patients with SBC diagnosed between 2006 and 2017 from Fudan University Shanghai Cancer Center were included in the study, excluding patients with previous malignant tumor history and incomplete clinical data or follow-up records. Peculiar clinicopathological and immunohistochemical features of the cases were fully described. Clinical data of 4979 cases of IDC were also evaluated during this period. After propensity score matching, prognostic analysis of SBCs and IDCs was calculated by Kaplan-Meier method and landmark analysis method. RESULTS The data of 52 patients diagnosed with SBC were identified from the pathological files. Among them, 47 patients were women, and 5 were men. The median age of the 52 SBCs was 46 years (mean, 48.1 years; range, 10-80 years). The tumor sizes ranged from 0.3 to 6.8 cm, with a mean of 3.5 cm. Eight patients (15.4%) had positive axillary lymph node involvement. The molecular classification was mostly triple-negative breast cancer (65.4%). Fluorescence in situ hybridization confirmed the presence of ETV6::NTRK3 rearrangement in 16 of 18 cases (88.9%). Furthermore, Kaplan-Meier survival analysis and landmark analysis demonstrated that there were no statistically significant differences in DFS and OS between SBC and IDC patients. CONCLUSION Although SBCs are generally associated with a favorable prognosis, our work exhibited that the clinicopathological features of SBC were partly different from former understandings, indicating that therapeutic procedure should be prudent. Further studies are necessary to fully identify the clinical behavior and predictive markers to improve diagnosis and management in this unique subtype of breast cancer.
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Affiliation(s)
- Yuan-Yuan Zhao
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Fudan University, 270 Dong-An Road, Shanghai, 200032, People's Republic of China
- Department of General Surgery, Huashan Hospital, Fudan University, 12 Urumqi Road (M), Shanghai, 200040, People's Republic of China
| | - Hui-Juan Ge
- Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong-An Road, Shanghai, 200032, People's Republic of China
- Department of Pathology, Fudan University Shanghai Cancer Center, Fudan University, 270 Dong-An Road, Shanghai, 200032, People's Republic of China
| | - Wen-Tao Yang
- Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong-An Road, Shanghai, 200032, People's Republic of China
- Department of Pathology, Fudan University Shanghai Cancer Center, Fudan University, 270 Dong-An Road, Shanghai, 200032, People's Republic of China
| | - Zhi-Ming Shao
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Fudan University, 270 Dong-An Road, Shanghai, 200032, People's Republic of China.
- Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong-An Road, Shanghai, 200032, People's Republic of China.
- Institutes of Biomedical Science, Fudan University, Shanghai, People's Republic of China.
| | - Shuang Hao
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Fudan University, 270 Dong-An Road, Shanghai, 200032, People's Republic of China.
- Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong-An Road, Shanghai, 200032, People's Republic of China.
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2
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Hassan N, Idaewor P, Rasheed N, Saad Abdalla Al-Zawi A. Paediatric and Adolescent Breast Cancer: A Narrative Review. Cureus 2023; 15:e48983. [PMID: 38024017 PMCID: PMC10656636 DOI: 10.7759/cureus.48983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2023] [Indexed: 12/01/2023] Open
Abstract
Breast cancer is the most prevalent form of cancer worldwide. Every year, it affects a significant number of women in the UK and is considered one of the leading causes of cancer-related deaths globally. While breast cancer is primarily linked to adult women, its occurrence in children and adolescents is exceedingly rare. This study conducted a narrative review spanning from 1999 to 2023, examining 32 case reports to investigate the characteristics of breast cancer in the paediatric age group. These reports focused on patients under 18 years old who were diagnosed with primary glandular breast cancer, excluding cases originating from other tissues like angiosarcoma, leukaemia, and metastatic cancer. The data analysis encompassed various parameters, including gender, age, histology, receptor status, lymph node involvement, treatment methods, and genetic characteristics. From the published case reports, it was concluded that the most common type of breast cancer affecting children and adolescents is secretory breast carcinoma and predominantly occurs in females. It is typically hormone receptors negative, and the preferred treatment approach involves mastectomy as breast conservation surgery to preserve the developing breast tissue is a real challenge due to limited breast tissue volume in this age group.
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Affiliation(s)
- Natalie Hassan
- Critical Care, Basildon University Hospital, Basildon, GBR
| | - Philip Idaewor
- Histopathology/Cellular Pathology, Mid and South Essex National Health Service (NHS) Foundation Trust, Basildon, GBR
- Histopathology/Cellular Pathology, Basildon and Thurrock University Hospital, Basildon, GBR
| | - Noreen Rasheed
- Radiology, Basildon and Thurrock University Hospital, Basildon, GBR
| | - Abdalla Saad Abdalla Al-Zawi
- General and Breast Surgery, Basildon and Thurrock University Hospital, Basildon, GBR
- General and Breast Surgery, Anglia Ruskin University, Chelmsford, GBR
- General and Breast Surgery, Mid and South Essex National Health Service (NHS) Foundation Trust, Basildon, GBR
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3
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MAZELLIER S, GHARBI M, PATE M, CHENARD MP, BRUANT-RODIER C, JANNIER S, AME S, LODI M, MATHELIN C. Surgical management of secretory breast carcinoma in children. CURRENT PROBLEMS IN CANCER: CASE REPORTS 2023. [DOI: 10.1016/j.cpccr.2023.100229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2023] Open
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4
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Davis J, Liang J, Roh A, Kittrell L, Petterson M, Winton L, Connell M, Viscusi R, Komenaka I, Jamshidi R. Use of breast imaging-reporting and data system (BI-RADS) ultrasound classification in pediatric and adolescent patients overestimates likelihood of malignancy. J Pediatr Surg 2021; 56:1000-1003. [PMID: 33494944 DOI: 10.1016/j.jpedsurg.2020.12.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 12/21/2020] [Accepted: 12/28/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND/PURPOSE Breast masses in the pediatric population cause patient and family concern, partially driven by public awareness of adult breast cancer. However, the spectrum of breast masses in children differs greatly from that in adults, and malignancy is exceedingly rare. The American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) ultrasound-based classification system is the diagnostic standard, yet no study has validated BI-RADS in pediatric patients. This study compares BI-RADS classification with histologic diagnoses to evaluate BI-RADS validity in pediatric patients. METHODS Multicenter retrospective evaluation of breast masses in patients under 21 years. Ultrasound reports were compared with histologic diagnoses. RESULTS There were 283 patients with breast pathology results after excluding clinical diagnoses of gynecomastia. Mean age was 16.9 (SD 2.3), ranging 10-20 years. 227 had pre-operative ultrasounds, and 84% (191/227) were assigned a BI-RADS category. BI-RADS 4 was the most frequent category (55%, n = 124), by definition predicting 2 - 95% likelihood of malignancy. However, pathology was benign in all patients. CONCLUSIONS The current BI-RADS categorization system overestimates cancer risk when applied to pediatric patients. BI-RADS scores should not be assigned to pediatric patients, and BIRADS-defined recommendations for biopsy should be disregarded. A pediatric-specific classification system could be useful.
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Affiliation(s)
- John Davis
- Valleywise Health Medical Center, Phoenix, AZ, United States
| | - Juliana Liang
- The University of Arizona College of Medicine, Phoenix, Phoenix, AZ, United States
| | - Albert Roh
- Valleywise Health Medical Center, Phoenix, AZ, United States
| | - Laurel Kittrell
- The University of Arizona College of Medicine, Tucson, Tucson, AZ, United States
| | - Matthew Petterson
- The University of Arizona College of Medicine, Phoenix, Phoenix, AZ, United States
| | - Lisa Winton
- Valleywise Health Medical Center, Phoenix, AZ, United States
| | - Mary Connell
- Valleywise Health Medical Center, Phoenix, AZ, United States
| | - Rebecca Viscusi
- The University of Arizona College of Medicine, Tucson, Tucson, AZ, United States
| | - Ian Komenaka
- Valleywise Health Medical Center, Phoenix, AZ, United States
| | - Ramin Jamshidi
- Valleywise Health Medical Center, Phoenix, AZ, United States; The University of Arizona College of Medicine, Phoenix, Phoenix, AZ, United States; Phoenix Children's Hospital, Phoenix, AZ, United States.
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5
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Novochadlo Klüppel E, Rodrigues da Costa L, Marquetto Tognolo C, do Nascimento A, Grignet Ribeiro M, Girardi Fachin C. Secretory breast carcinoma in a male child: Case report and literature review. Int J Surg Case Rep 2020; 73:310-314. [PMID: 32736235 PMCID: PMC7394736 DOI: 10.1016/j.ijscr.2020.07.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 11/28/2022] Open
Abstract
Even slow growing mammary lesions in a male child may be malignant. Secretory breast cancer positive for estrogen and progesterone receptors is very rare in a male child. Secretory breast cancer after surgical excision usually does not require adjuvant therapy.
Introduction The secretory breast carcinoma is very rare in children. It represents less than 1% of malignancy cases in childhood and is even less common in males, with 15 cases reported until 2004. Therefore, the aim of this study is to report a male child with breast carcinoma and review literature. Presentation of case A 14-year-old male patient with a history of a painless slow-growing lump in the left breast and, five years later, onset of yellow discharge from the papilla. Ultrasound scanning demonstrated a well- defined, regular, homogeneous and hypoechoic mass. Nodule excision was initially performed, followed by mastectomy, due to compromised radial margin. Immunohistochemistry revealed weakly positive estrogen and progesterone receptors. Adjuvant therapy was not required. Sixteen months after resection, the patient is well with no complaints or recurrence. Discussion Due to its rarity, there is no therapeutic guideline. Although the recommended treatment is still surgical excision, there is no consensus as to its extent. Prognosis is usually favorable. Our patient was submitted to mastectomy with sentinel lymph node biopsy due to compromised radial margin. Conclusion Secretory breast carcinoma is a rare form of breast cancer, especially in male children; which hampers standardization of diagnosis, treatment and prognosis establishment.
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Affiliation(s)
| | | | | | - Alexandre do Nascimento
- Pathology Department, Hospital de Clínicas, Federal University of Paraná, Curitiba, PR, Brazil
| | - Melyssa Grignet Ribeiro
- Pathology Department, Hospital de Clínicas, Federal University of Paraná, Curitiba, PR, Brazil
| | - Camila Girardi Fachin
- Pediatric Surgery, Hospital de Clínicas, Federal University of Paraná, Curitiba, PR, Brazil.
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Garlick JW, Olson KA, Downs-Kelly E, Bucher BT, Matsen CB. Secretory breast carcinoma in an 8-year-old girl: A case report and literature review. Breast J 2018; 24:1055-1061. [DOI: 10.1111/tbj.13126] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 12/07/2017] [Accepted: 12/12/2017] [Indexed: 12/18/2022]
Affiliation(s)
- Jared W. Garlick
- Division of Plastic Surgery; University of Utah; Salt Lake City Utah
| | - Kristofor A. Olson
- Department of Surgery and Perioperative Care; Dell Medical School; University of Texas at Austin; Austin Texas
| | - Erinn Downs-Kelly
- Cleveland Clinic; Pathology and Laboratory Medicine Institute; Cleveland Ohio
| | - Brian T. Bucher
- Division of Pediatric Surgery; Primary Children’s Hospital; Salt Lake City Utah
| | - Cindy B. Matsen
- Division of General Surgery, Huntsman Cancer Institute; University of Utah; Salt Lake City Utah
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7
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Male secretory breast cancer: case in a 6-year-old boy with a peculiar gene duplication and review of the literature. Breast Cancer Res Treat 2018; 170:445-454. [DOI: 10.1007/s10549-018-4772-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 03/27/2018] [Indexed: 10/17/2022]
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Jacob JD, Hodge C, Franko J, Pezzi CM, Goldman CD, Klimberg VS. Rare breast cancer: 246 invasive secretory carcinomas from the National Cancer Data Base. J Surg Oncol 2016; 113:721-5. [PMID: 27040042 DOI: 10.1002/jso.24241] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Accepted: 03/16/2016] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVES Invasive secretory breast carcinoma (SBC) is a rare subtype of breast malignancy. METHODS Cases of SBC and infiltrating ductal carcinoma (IDC) from the National Cancer Database (1998-2011) were queried. RESULTS Patients with SBC (n = 246) and IDC were identified (n = 1,564,068). The group with SBC was younger (age 56.4 ± 16.0 vs. 60.4 ± 13.9 years, P < 0.001), had similar tumor size (19.9 ± 17.8 vs. 21.6 ± 25.5 mm, P = 0.297), more frequently African-Americans (24.1 vs. 14.8 vs. 13.7; P = 0.004), more well-differentiated (32 vs. 18%, P < 0.001) and less likely to be hormone receptor positive (ER: 64 vs. 76%, P = 0.001; PR: 43 vs. 65%, P < 0.001). No differences were found for incidence of node-positivity (32 vs. 34%, P = 0.520) and stage IV presentation (2.4 vs. 3.6%, P = 0.372). Breast conserving surgery (60 vs. 58%, P = 0.405) and hormonal therapy (67 vs. 71%, P = 0.489) rates were similar. Systemic chemotherapy was used less often for SBC (38 vs. 45%, P = 0.035). The overall survival of all patients with SBC was better than all patients with IDC (median not reached vs. 14.8 years, P = 0.025). CONCLUSION SBC is an uncommon tumor that is often well-differentiated and seen in younger women. Contrary to prior reports, they are frequently hormone receptor-positive. Compared to IDC, overall survival is improved. J. Surg. Oncol. 2016;113:721-725. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- John Doromal Jacob
- Department of Surgery, Abington Hospital-Jefferson Health, Abington, Pennsylvania
| | - Caitlin Hodge
- Department of Surgery, Abington Hospital-Jefferson Health, Abington, Pennsylvania
| | - Jan Franko
- Surgical Affiliates, Mercy Medical Center, Des Moines, Iowa
| | - Christopher M Pezzi
- Department of Surgery, Abington Hospital-Jefferson Health, Abington, Pennsylvania
| | | | - Vicki Suzanne Klimberg
- Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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9
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Valeur NS, Rahbar H, Chapman T. Ultrasound of pediatric breast masses: what to do with lumps and bumps. Pediatr Radiol 2015; 45:1584-99; quiz 1581-3. [PMID: 26164440 DOI: 10.1007/s00247-015-3402-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Revised: 04/15/2015] [Accepted: 06/01/2015] [Indexed: 10/23/2022]
Abstract
The approach to breast masses in children differs from that in adults in many ways, including the differential diagnostic considerations, imaging algorithm and appropriateness of biopsy as a means of further characterization. Most pediatric breast masses are benign, either related to breast development or benign neoplastic processes. Biopsy is rarely needed and can damage the developing breast; thus radiologists must be familiar with the imaging appearance of common entities so that biopsies are judiciously recommended. The purpose of this article is to describe the imaging appearances of the normally developing pediatric breast as well as illustrate the imaging findings of a spectrum of diseases, including those that are benign (fibroadenoma, juvenile papillomatosis, pseudoangiomatous stromal hyperplasia, gynecomastia, abscess and fat necrosis), malignant (breast carcinoma and metastases), and have variable malignant potential (phyllodes tumor).
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Affiliation(s)
- Natalie S Valeur
- Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA
| | - Habib Rahbar
- Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA.,Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Teresa Chapman
- Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA. .,Department of Radiology, Seattle Children's Hospital, Mail Stop MA.07.220, P.O. Box 5371, Seattle, WA, 98145, USA.
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10
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Soyer T, Yaman Bajin İ, Orhan D, Yalçin B, Özgen Kiratli P, Oğuz B, Karnak İ. Secretory breast carcinoma in a 6-year-old girl: mastectomy with sentinel lymph node dissection. Pediatr Surg Int 2015; 31:677-81. [PMID: 25994562 DOI: 10.1007/s00383-015-3721-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/12/2015] [Indexed: 12/20/2022]
Abstract
Secretory breast carcinoma (SBC) is a rare type of breast neoplasia that was originally described in children. SBC is an indolent breast tumor with good clinical outcome and rare systemic involvement. Since, majority of studies concerning pediatric SBC have been case reports, it has been difficult to clearly elucidate the characteristics and optimal treatment strategies for SBC in children. Although treatment recommendations vary, surgical excision is the primary mode of treatment. Also, necessity of axillary and/or sentinel lymph node dissection is another matter of discussion in children. We report a 6-year-old girl who was diagnosed as SBC was reported to discuss the use of mastectomy with sentinel lymph node dissection in the treatment of this rare tumor in children.
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Affiliation(s)
- Tutku Soyer
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey,
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11
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Li G, Zhong X, Yao J, Chen J, Wang M, Liu H, Yang S. Secretory breast carcinoma in a 41-year-old man with long-term follow-up: a special report. Future Oncol 2015; 11:1767-73. [PMID: 26075445 DOI: 10.2217/fon.15.60] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Secretory breast carcinoma (SBC) is a rare tumor that is particularly rare in male adults. To our knowledge, only 28 previous male cases of secretory breast carcinoma have been reported. We present a case of secretory breast carcinoma that has the longest duration of symptoms (40 years) in a male individual until now. Typically, the clinical features and treatment of male SBC are similar with female SBC. The ETV6–NTRK3 fusion gene is a specific genetic alteration in SBC. When compared to other types of male breast cancer, patients with male secretory breast cancer are much younger, and have a lower rate of estrogen/progesterone hormone receptor positivity. Modified radical mastectomy has been favored as a therapeutic approach in all female SBC, male SBC and other types of male breast cancer.
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Affiliation(s)
- Guanqiao Li
- Department of Breast Surgery, Hainan Province People's Hospital, Haikou, Hainan, PR China
| | - Xiaojie Zhong
- Department of Breast Surgery, Hainan Province People's Hospital, Haikou, Hainan, PR China
| | - Jia Yao
- Department of Breast Surgery, Hainan Province People's Hospital, Haikou, Hainan, PR China
| | - Jimin Chen
- Department of Pathology, Hainan Province People's Hospital, Haikou, Hainan, PR China
| | - Mei Wang
- Department of Breast Surgery, Hainan Province People's Hospital, Haikou, Hainan, PR China
| | - Haiying Liu
- Department of Breast Surgery, Hainan Province People's Hospital, Haikou, Hainan, PR China
| | - Shiping Yang
- Department of Radiation Oncology, Hainan Province People's Hospital, Haikou, Hainan, PR China
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12
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Ganesh SA, Muralee M, Sukumaran R, Ahamed MI. Secretory carcinoma of breast in a patient treated for differentiated thyroid carcinoma-a diagnostic dilemma. Indian J Surg Oncol 2014; 5:246-8. [PMID: 25419077 DOI: 10.1007/s13193-014-0344-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 07/28/2014] [Indexed: 11/28/2022] Open
Abstract
Secretory carcinoma of the breast is a rare entity accounting for less than 1 % of all infiltrating breast carcinomas. Though initially considered as "juvenile breast carcinoma", due to its occurrence predominantly in pediatric population, it was later found to present in other age groups as well. We report a case of secretory carcinoma breast in a middle aged woman who had undergone treatment for papillary carcinoma of thyroid previously. The uniqueness of this malignancy and the diagnostic dilemma due to patient's past medical history, are discussed in detail.
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Affiliation(s)
- S Alagu Ganesh
- Department of Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, India
| | - Madhu Muralee
- Department of Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, India
| | - Renu Sukumaran
- Department of Pathology, Regional Cancer Centre, Thiruvananthapuram, India
| | - M Iqbal Ahamed
- Department of Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, India
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13
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Wang YQ, Wang Y, Zhang JH, Li YF, Li HM, Wang L, Yao Y. Secretory breast carcinoma in a 12-year-old girl: A case report. Oncol Lett 2014; 8:1635-1637. [PMID: 25202382 PMCID: PMC4156222 DOI: 10.3892/ol.2014.2380] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 06/13/2014] [Indexed: 11/26/2022] Open
Abstract
Secretory breast carcinoma (SBC) is a rare tumor that was originally described in children and adolescent women, with a characteristic morphology and controversy regarding the choice of treatment. This unusual breast cancer subtype generally has a favorable prognosis, although several cases have been described in adults with increased tumor aggressiveness and a risk of metastases. Surgery is considered the most appropriate treatment for this pathology. The present study describes the case of a 12-year-old female who presented with a painless lump in the left breast, and subsequently underwent a biopsy of the sentinel lymph node and a partial resection of the left breast (breast-conserving therapy). Periodic follow-up examinations after completion of the surgical and chemotherapeutic treatment have shown no evidence of either local regression or distant metastases and, one year later, the patient remains free of the disease. This study suggests that local excision with sentinel lymph node mapping may be a suitable therapeutic approach for children with SBC
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Affiliation(s)
- Ya-Qi Wang
- Department of Breast Cancer Surgery, Tangshan People's Hospital, Tangshan, Tangshan, Hebei 063001, P.R. China ; Graduate Department, Hebei United University, Tangshan, Tangshan, Hebei 063001, P.R. China
| | - Yu Wang
- Department of Breast Cancer Surgery, Tangshan People's Hospital, Tangshan, Tangshan, Hebei 063001, P.R. China
| | - Jing-Hua Zhang
- Department of Breast Cancer Surgery, Tangshan People's Hospital, Tangshan, Tangshan, Hebei 063001, P.R. China ; Graduate Department, Hebei United University, Tangshan, Tangshan, Hebei 063001, P.R. China ; Central Laboratory, Cancer Institute, Tangshan People's Hospital, Tangshan, Tangshan, Hebei 063001, P.R. China ; Department of Pathology, Tangshan People's Hospital, Tangshan, Tangshan, Hebei 063001, P.R. China ; Department of Gastrointestinal Tumor Surgery, Tangshan People's Hospital, Tangshan, Tangshan, Hebei 063001, P.R. China ; Breast Disease Prevention and Control Center, Tangshan, Tangshan, Hebei 063001, P.R. China
| | - Yu-Feng Li
- Central Laboratory, Cancer Institute, Tangshan People's Hospital, Tangshan, Tangshan, Hebei 063001, P.R. China
| | - Hong-Min Li
- Department of Pathology, Tangshan People's Hospital, Tangshan, Tangshan, Hebei 063001, P.R. China
| | - Lei Wang
- Department of Pathology, Tangshan People's Hospital, Tangshan, Tangshan, Hebei 063001, P.R. China
| | - Yuan Yao
- Department of Gastrointestinal Tumor Surgery, Tangshan People's Hospital, Tangshan, Tangshan, Hebei 063001, P.R. China
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14
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Ahmed ST, Singh SK, Mukherjee T, Banerjee M. Breast carcinoma in a prepubertal girl. BMJ Case Rep 2014; 2014:bcr-2013-203251. [PMID: 24810441 DOI: 10.1136/bcr-2013-203251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Breast carcinoma is a very rare disease in children. We present a rare case of breast cancer in an 11-year-old prepubertal girl. Clinically, it was a case of locally advanced breast cancer (T4bN1M0). The core biopsy report showed adenocarcinoma of the not otherwise specified (NOS) variety (oestrogen receptor-negative, progesterone receptor-negative and human epidermal growth factor receptor 2-negative). Diagnosis was late in this case due to lack of suspicion. A modified radical mastectomy was considered to be adequate treatment. Histologically, it was adenocarcinoma NOS, which is rare in young girls (the secretory type being more common). Incidence, differential diagnoses, investigation and management of breast carcinoma in young girls are discussed. The purpose of reporting this case is to highlight that prevention and early detection of breast carcinoma in children is very important.
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Affiliation(s)
- Syed Tausif Ahmed
- Department of General Surgery, RGKAR Hospital, Kolkata, West Bengal, India
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15
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Case report: Secretory breast cancer in an 11-year-old girl. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2013. [DOI: 10.1016/j.epsc.2013.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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16
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Cadoo KA, McArdle O, O'Shea AM, Power CP, Hennessy BT. Management of unusual histological types of breast cancer. Oncologist 2012; 17:1135-45. [PMID: 22826373 DOI: 10.1634/theoncologist.2012-0134] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
There is increased understanding of the heterogeneity of breast tumors, with greater emphasis now being placed on histological and molecular profiles and, in particular, their implications for prognosis and therapy. This review addresses breast cancers of unusual histological subtype with an approximate incidence ≤1%. Given the rarity of these tumors, the literature contains primarily case reports, small series, and population-based studies. Data are heterogeneous and almost entirely retrospective, frequently gathered over long time periods, in the context of changing pathological techniques and reporting. In addition, our understanding of the disease biology and therapeutic context has also evolved significantly over this time. There is often limited information about the specific therapies used and the rationale for choosing such an approach. Meaningful comparisons of treatment modalities are not feasible and it is not possible to define management guidelines. Instead, this review correlates the available information to give an impression of how each subgroup behaves-of the favored surgical technique, responses to therapy, and prognosis-as well as the emerging molecular data, highlighting new research areas for potential target in clinical trials. Each tumor subtype described represents a small but real cohort of patients with breast cancer, and although inferences may be made from this review, we are mindful of the paucity of data. The management of each patient must be considered in the context of their unique clinical presentation and correlated with the evidence-based principles that apply to more common breast cancer histologies.
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MESH Headings
- Adenocarcinoma/diagnosis
- Adenocarcinoma/pathology
- Adenocarcinoma/therapy
- Breast Neoplasms/classification
- Breast Neoplasms/diagnosis
- Breast Neoplasms/pathology
- Breast Neoplasms/therapy
- Carcinoma/diagnosis
- Carcinoma/pathology
- Carcinoma/therapy
- Carcinoma, Adenoid Cystic/diagnosis
- Carcinoma, Adenoid Cystic/pathology
- Carcinoma, Adenoid Cystic/therapy
- Carcinoma, Ductal, Breast/diagnosis
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/therapy
- Carcinoma, Papillary/diagnosis
- Carcinoma, Papillary/pathology
- Carcinoma, Papillary/therapy
- Female
- Humans
- Prognosis
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Affiliation(s)
- Karen A Cadoo
- Evelyn H. Lauder Breast Center, Memorial Sloan-Kettering Cancer Center, 300 East 66th Street, New York, NY 10065, USA.
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Secretory breast carcinoma: a clinicopathological and immunophenotypic study of 15 cases with a review of the literature. Mod Pathol 2012; 25:567-75. [PMID: 22157932 DOI: 10.1038/modpathol.2011.190] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Secretory breast carcinoma is a rare breast cancer with indolent clinical behavior. Recent research showed that secretory breast carcinoma belongs to the phenotypic spectrum of basal-like breast carcinomas. In this study, a clinicopathological and immunophenotypic analysis of secretory breast carcinomas from 15 Chinese patients was conducted. This patient group consisted of 2 males and 13 females, with ages ranging from 10 to 67 years old (median, 36 years old). All patients presented with a painless and firm mass. Tumor size ranged from 10 to 55 mm. Most tumors were located in the outer upper quadrant of the breast. Two patients (2 of 13, 15%) displayed positive axillary lymph nodes. At the microscopic level, the presence of intracellular and extracellular secretory material was the most remarkable feature. Most cases showed mild dysplasia cytologically. All cases were negative for estrogen receptor, progesterone receptor and HER2. The expression rate of the basal-like marker (CK5/6 or epidermal growth factor receptor) was 87% (13 of 15). The basal-like phenotype was identified in 13 cases (87%). Follow-up time ranged from 10 to 55 months (median, 19 months). None of the cases had evidence of recurrence and metastasis. Our study reveals that secretory breast carcinoma is a distinct subset of invasive breast carcinoma, with expression of basal-like markers. It should be noted that secretory breast carcinoma is different from conventional basal-like breast carcinomas. Future studies are required to further understand the prognostic significance of the basal-like markers expression in secretory breast carcinomas.
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18
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Yorozuya K, Takahashi E, Kousaka J, Mouri Y, Yoshida M, Fujii K, Akizuki M, Nakano S, Fukutomi T, Umemoto Y, Yokoi T, Imai H. A Case of Estrogen Receptor Positive Secretory Carcinoma in a 9-Year-old Girl With ETV6-NTRK3 Fusion Gene. Jpn J Clin Oncol 2011; 42:208-11. [DOI: 10.1093/jjco/hyr187] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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19
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Cabello C, Alvarenga M, Alvarenga CA, Duarte GM, Pereira PN, Marshall PS. Case report and review of the literature: secretory breast cancer in a 13-year-old boy--10 years of follow up. Breast Cancer Res Treat 2011; 133:813-20. [PMID: 22083230 DOI: 10.1007/s10549-011-1869-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2011] [Accepted: 10/31/2011] [Indexed: 11/25/2022]
Abstract
Carcinoma of the breast is very rare in childhood, accounting for less than 1% of all childhood malignancies and is especially rare in boys. Delay in diagnosis and treatment in children with breast cancer may occur because surgeons are very reluctant to perform biopsies on the developing breast, since these can cause future deformity. We report a case of male secretory breast carcinoma in a 13-year-old boy. Radical mastectomy was performed followed by chemotherapy. The patient is free of disease after 10 years. Secretory breast carcinoma (SBC) is the commonest type of breast carcinoma in children. In this article, we discuss the diagnosis and treatment options for breast cancer among children as well as features of SBC, based on a literature review.
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Affiliation(s)
- Cesar Cabello
- University of Campinas, Av. Alexander Flemming, 101, Cidade Universitária, Campinas, SP 13083-881, Brazil.
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20
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Sorelli PG, Thomas D, Moore A, Khan M, Hoque H. Malignant phyllodes tumor in an 11-year-old premenarchal girl. J Pediatr Surg 2010; 45:e17-20. [PMID: 20152333 DOI: 10.1016/j.jpedsurg.2009.12.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2009] [Revised: 12/06/2009] [Accepted: 12/06/2009] [Indexed: 11/16/2022]
Abstract
Phyllodes tumor is uncommon in children, and the malignant form is rare. There have only been a few cases of benign phyllodes tumor reported in peripubertal children and only one malignant case. We report the second case of malignant phyllodes tumor in a premenarchal 11-year-old girl.
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Affiliation(s)
- Paolo G Sorelli
- Department of Surgery, Queen Mary's Hospital, Sidcup DA14 6LT, United Kingdom.
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21
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Gow KW, Rapkin LB, Olson TA, Durham MM, Wyly B, Shehata BM. Sentinel lymph node biopsy in the pediatric population. J Pediatr Surg 2008; 43:2193-8. [PMID: 19040933 DOI: 10.1016/j.jpedsurg.2008.08.063] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2008] [Accepted: 08/29/2008] [Indexed: 12/11/2022]
Abstract
BACKGROUND Sentinel lymph node biopsy (SLNB) has only been recently used for childhood neoplasms. METHODS We reviewed all patients younger than 19 years who underwent SLNB for 5 years. RESULTS Twenty patients were identified (11 male, 9 female). Sentinel lymph node biopsy was performed for 10 sarcomas (5 synovial, 3 rhabdomyosarcoma, 1 epitheliod, 1 other); 9 skin neoplasms (4 melanomas, 3 Spitz nevi, 2 melanocytomas); and 1 acinic cell carcinoma. All patients underwent Technetium 99m sulfur microcolloid injection and 4-quadrant subdermal injection with Lymphazurin 1% (Autosuture, Norwalk, Conn). Six patients required either sedation for lymphoscintigraphy. Intraoperative gamma probe was used. Primary lesions were found in lower extremity (n = 8), upper extremity (n = 6), trunk (n = 3), and head and neck (n = 3). The lymphatic basins were inguinal (n = 8), axilla (n = 8), neck (n = 3), and both inguinal and axilla (n = 1). At least one lymph node was identified in each procedure. Of 20 patients, 5 (25%) had metastatic disease (4 skin neoplasms and 1 sarcoma). There were no complications in our series, and all patients are alive with no recurrence at an average follow-up of 2.2 years. CONCLUSIONS Sentinel lymph node biopsy allows for an accurate biopsy in children. However, some younger patients may require sedation, and it may be more challenging to isolate the sentinel node.
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Affiliation(s)
- Kenneth W Gow
- Division of Pediatric Surgery, Department of Surgery, Emory School of Medicine, Atlanta, GA, USA.
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22
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Mun SH, Ko EY, Han BK, Shin JH, Kim SJ, Cho EY. Secretory carcinoma of the breast: sonographic features. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2008; 27:947-954. [PMID: 18499854 DOI: 10.7863/jum.2008.27.6.947] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE The purpose of this series was to evaluate the sonographic features of secretory carcinoma of the breast. METHODS Between 1994 and 2006, 9 patients had histologically confirmed secretory carcinoma of the breast in our institution, and 6 of them underwent breast sonography. We retrospectively evaluated the sonographic findings of the patients in correlation with other available images and reviewed the clinical records. RESULTS Clinical manifestations were a palpable mass (n=3), a bloody nipple discharge (n=1), and screening-detected abnormalities (n=2). Breast sonograms showed masses with a round or oval (n=5) or tubular (n=1) shape, with relatively well-circumscribed (n=2) or partially microlobulated (n=4) margins, and with a hypoechoic (n=4) or an isoechoic (n=2) internal echo texture. Most lesions were single nodules (n=3) or groups of nodules (n=2) measuring 1 cm or smaller, except 1 mass measuring 3.5 cm with axillary lymph node metastasis. Two cases had associated ductectasia. Sonographic assessments were classified as Breast Imaging Reporting and Data System category 3 in 2 cases, category 4A in 3 cases, and category 4B in 1 case. CONCLUSIONS Secretory carcinoma of the breast is frequently shown as a small benign-looking nodule or group of nodules or sometimes as an intraductal lesion with a low clinical stage on sonography. Although secretory carcinoma is a rare breast malignancy, awareness of its sonographic features will be helpful for the differential diagnosis.
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Affiliation(s)
- Sung Hee Mun
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Korea
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23
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Gutierrez JC, Housri N, Koniaris LG, Fischer AC, Sola JE. Malignant Breast Cancer in Children: A Review of 75 Patients. J Surg Res 2008; 147:182-8. [DOI: 10.1016/j.jss.2008.03.026] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2008] [Revised: 03/12/2008] [Accepted: 03/14/2008] [Indexed: 11/25/2022]
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Kayton ML, Delgado R, Busam K, Cody HS, Athanasian EA, Coit D, La Quaglia MP. Experience with 31 sentinel lymph node biopsies for sarcomas and carcinomas in pediatric patients. Cancer 2008; 112:2052-9. [DOI: 10.1002/cncr.23403] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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25
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Abstract
Male breast cancer is a rare condition with scant research into its psychosocial impact. This phenomenologic study sought to elicit its lived experience. Following analysis of interview data, 4 key themes emerged: Living with male breast cancer, concealment as a strategy for managing the diagnosis, a contested masculinity, interacting with health services. Male breast cancer constitutes a unique lived experience for men that is unparalleled in other disease profiles. The idea of living with a feminized illness was very distressing and stigmatizing for some men. Furthermore, treatment resulted in a profound change to the concept of their embodied selves and constituted a significant change to body image and sexuality. This was reinforced in participants who experienced erectile dysfunction related to tamoxifen therapy. Sadly, some health professionals were unable to offer specific psychosocial support, and participants felt marginalized from the potential benefits of the treatment environment. However, participants adapted to the illness by reasserting and renegotiating masculinity and finding ways to accommodate life with a stigmatizing condition and an altered body image.
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26
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Vieni S, Cabibi D, Cipolla C, Fricano S, Graceffa G, Latteri MA. Secretory breast carcinoma with metastatic sentinel lymph node. World J Surg Oncol 2006; 4:88. [PMID: 17150092 PMCID: PMC1764883 DOI: 10.1186/1477-7819-4-88] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2006] [Accepted: 12/06/2006] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Secretory mammary carcinoma is a rare breast neoplasia originally described in children but sometimes also found in adults. It presents a more favourable outcome than more common histological types of breast carcinoma; published literature in fact reports only a few cases with axillary lymph node metastases and only four cases with distant metastases. CLINICAL PRESENTATION In this paper we report a rare case of secretory breast carcinoma with axillary lymph node metastases in a 33-year-old woman. To our knowledge, this is the first case of secretory carcinoma involving biopsy of the sentinel lymph node and investigation of the e-cadherin expression. We found positivity for e-cadherin, which would support the hypothesis that this type of tumour is a variant of the infiltrating ductal carcinoma. CONCLUSION After a careful analysis of reported data, we have come to the conclusion that the treatment of choice for patients with secretory breast carcinoma should be conservative surgery with sentinel lymph node biopsy, followed by accurate follow-up. We are of the opinion that while post-operative radiotherapy is indicated in adult patients who have undergone quadrantectomy, it should not be used in children. Although several cases of secretory carcinoma have been treated with adjuvant chemotherapy, there are still no reliable data regarding the real value of such a choice.
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Affiliation(s)
- Salvatore Vieni
- Department of Oncology, Division of General and Oncological Surgery, University of Palermo, Palermo, Italy
| | - Daniela Cabibi
- Institute of Pathology, University of Palermo, Palermo, Italy
| | - Calogero Cipolla
- Department of Oncology, Division of General and Oncological Surgery, University of Palermo, Palermo, Italy
| | - Salvatore Fricano
- Department of Oncology, Division of General and Oncological Surgery, University of Palermo, Palermo, Italy
| | - Giuseppa Graceffa
- Department of Oncology, Division of General and Oncological Surgery, University of Palermo, Palermo, Italy
| | - Mario Adelfio Latteri
- Department of Oncology, Division of General and Oncological Surgery, University of Palermo, Palermo, Italy
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