Secretory breast carcinoma with metastatic sentinel lymph node

Department of Oncology, Division of General and Oncological Surgery, University of Palermo, Palermo, Italy.
World Journal of Surgical Oncology (Impact Factor: 1.41). 02/2006; 4(1):88. DOI: 10.1186/1477-7819-4-88
Source: PubMed


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.
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.
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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    • "The mean tumor size is 3 cm. The literature mentions nodal involvement in 15% of the patients at presentation [8]. Although rare, metastatic disease at presentation has also been reported [9]. "
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    ABSTRACT: Secretory carcinoma of the breast is an extremely rare subtype of breast cancer characterized by intracellular or extracellular secretion and granular eosinophilic cytoplasm of the neoplastic cells. The disease which was considered to be predominant in younger age group has been recognized in adult population too and tends to show slow growth and indolent behavior. The disease occurs preferentially in females and only 27 cases have been reported amongst males. An optimal treatment for the disease subtype has been debated because of the paucity of data. We report two cases (one female and one male) of this rare disease that underwent treatment at our institution.
    Case Reports in Oncological Medicine 08/2015; 2015:581892. DOI:10.1155/2015/581892
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    • "Thus, conservative treatment without lymph node examination has been frequently proposed (17). However, axillary lymph node metastasis has been reported from a 1.5-cm secretory tumor (18). Furthermore, a previous study reported that 54 out of 83 patients were diagnosed with regional lymph node metastasis (1). "
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    ABSTRACT: Secretory breast carcinoma is a very rare and distinct subtype of breast cancer, characterized by the presence of intracellular and extracellular secretory material. Secretory breast carcinoma has a good clinical outcome and systemic involvement is rare. The majority of studies of this tumor have been case reports or separate analyses, and due to the rarity of these tumors, it has been difficult to fully elucidate their characteristics and define optimal treatment strategies. To add to the current knowledge of secretory breast carcinoma, the present study reports three cases of secretory breast carcinoma in patients of different ages, and with different hormone receptor statuses and treatment methods. The present study identified that each patient with secretory breast carcinoma may present with different symptoms and clinical characteristics. Therefore, therapeutic options should be selected based on the overall status of the patient and the characteristics of this rare disease.
    Oncology letters 08/2014; 8(2):683-686. DOI:10.3892/ol.2014.2213 · 1.55 Impact Factor
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    • "Besides, it is negative for estrogen receptor, progesterone receptor and HER-2/neu.19 In the current case, there were no basaloid cells and basement membrane-like material in the lumen, both of which are the histopathologic findings of the adenoid cystic carcinoma, and there was a positive response to estrogen receptor and progesterone receptor by immunohistochemistry. Secretory carcinoma has similar characteristics to lactating mammary glands and it is characterized by extensive secretions.20 However, these findings were not seen in our case. "
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    ABSTRACT: Phyllodes tumor is an uncommon fibroepithelial neoplasm of the breast. And it is characterized by expanded stroma with increased cellularity and elongated epithelium-lined clefts. Mammary carcinomas within phyllodes tumors have been rarely reported. To date, however, no reports have described the invasive cribriform carcinoma arising in malignant phyllodes tumor. Here, we report a 62-year-old woman who presented with a large breast mass. Microscopically, the mass was a typical malignant phyllodes tumor showing well developed leaf-like architecture and stromal overgrowth with high cellularity and nuclear pleomorphism. In a portion of the tumor, however, the epithelial component showed a cribriform pattern of proliferation in the absence of myoepithelial cells, suggestive of the invasive cribriform carcinoma. To our knowledge, this is rare and it is difficult to make a differential diagnosis of it. Here, we report our case with a review of literatures.
    04/2012; 46(2):205-9. DOI:10.4132/KoreanJPathol.2012.46.2.205
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