Clinicopathologic profiling and oncologic outcomes of secretory carcinoma of the breast

Abstract

Secretory carcinoma of the breast (SCB) is a rather rare entity of invasive breast cancer, the clinicopathologic characteristics and survival outcomes remain to be elaborated. A retrospective review was conducted in SEER database. A total of 190 SCB patients identified in SEER were eligible for inclusion in the analysis. Median age at diagnosis was 56 years (range 2–96 years). Both sexes and bilateral breast could be affected. Intriguingly, the incidence of SCB tended towards to decreasing in recent decades. Small tumor burden was observed with a mean tumor size of 2.13 cm. In a subgroup with sufficient details, positive staining of estrogen receptor (ER) and progesterone receptor (PR) was 58% and 40%, respectively. The vast majority of patients were of well to moderate differentiation (86.86%) and negative regional lymph nodes involvement (70.71%). Nearly half of the patients took radiotherapy and chemotherapy. Seniors were inclined to have an inferior breast cancer specific survival (BCSS) than their younger counterparts (P = 0.018). Patients underwent breast conserving surgery (BCS) and radiotherapy had much better BCSS than its mastectomy counterparts (P = 0.014). Collectively, SCB is a clinical indolent invasive breast cancer with excellent prognosis. BCS in conjunction with radiotherapy would be a rational alternative for this distinct entity.

Advancement of secretory breast carcinoma: a narrative review

“…Notably, in the small series composed exclusively of pediatric and adolescent patients, males also were the majority among pediatric patients with predominantly low-grade and early-stage tumors (12). Interestingly, the incidence of SBC has been declining in recent decades, which may be related to the reduction of the misdiagnosis rate resulting from the enhanced understanding of SBC and the improvement of diagnostic technology (8).…”

“…However, recent large-sample studies have concluded that SBC mimics the immune spectrum of hormone receptorpositive cancer rather than TNBC. According to the SEER database, 58% and 40% of 99 patients with SBC stained positive for ER and PR, respectively (8) (17). Generally, P63 nuclear staining is used as an effective marker of myoepithelial cells to determine the invasive status of breast cancer (36).…”

“…It is possible for SBC to occur at any age, regardless of gender. According to the retrospective analyses from Gong et al ( 8 ) and Jacob et al ( 9 ) [incorporating 190 patients with SBC in the Survival, Epidemiology, and End Results (SEER) database and 246 patients with SBC in the National Cancer Database (NCDB), respectively], the median age at diagnosis is 56 years (range, 2 to 96 years), the average age at diagnosis is 56 years (range, 18 to 89 years), and the male to female ratio is 1:30 to 1:31. However, previous literature reported a median age at diagnosis of 25 years (range, 3 to 83 years), and a male to female ratio of 1:6 ( 10 ).…”

“…Interestingly, the incidence of SBC has been declining in recent decades, which may be related to the reduction of the misdiagnosis rate resulting from the enhanced understanding of SBC and the improvement of diagnostic technology ( 8 ).…”

PTHrP induces STAT5 activation, secretory differentiation and accelerates mammary tumor development

“…Despite an apparent shift to a more differentiated state, tumors continued to metastasize, and cells derived from the tumors overexpressing PTHrP were able to form new tumors when transplanted into non-transgenic mice. The histological appearance of the tumors in Tet-PTHrP;PyMT mice, their expression of pSTAT5 and the accumulation of milk-like secretions is reminiscent of a rare type of human breast cancer known as “secretory carcinoma of the breast” [ 77 – 81 ]. The majority of these tumors have been shown to contain t(12;15)(p13;q25) chromosomal translocations that results in a fusion oncogene (ETV6-NTRK3) consisting of the oligomerization domain of ETV6 fused to the protein tyrosine kinase domain of the neurotropin 3 receptor (NTRK3).…”