Juvenile secretory carcinoma of the breast

Karl, Stephen R.; Ballantine, Thomas V.N.; Zaino, Richard J.

doi:10.1016/s0022-3468(85)80221-9

Cited by 74 publications

(62 citation statements)

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“…A total of 27 cases (including 2 cases from our study, see Table 3) of male patients with secretory breast carcinoma could be identified in the literature. 2,3,6,9,23,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] Most affected patients were children and adolescents with a median age of 27 years. The tumors are usually located subareolarly.…”

Section: Discussionmentioning

confidence: 99%

Secretory breast carcinoma: a clinicopathological and immunophenotypic study of 15 cases with a review of the literature

Xiao

Yang

et al. 2012

Modern Pathology

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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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Section: Discussionmentioning

confidence: 99%

Secretory breast carcinoma: a clinicopathological and immunophenotypic study of 15 cases with a review of the literature

Xiao

Yang

et al. 2012

Modern Pathology

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“…12 Karl et al indicated that secretory carcinoma of the breast does not develop in response to raised circulating oestrogen levels. 5 From these findings, the breast carcinoma in our patient did not seem to be directly connected with gynaecomastia resulting from liver disease. Nevertheless, our case shows that secretory carcinoma of the breast can and rarely does occur in the elderly male.…”

Section: ) Tavassoli and Norrismentioning

confidence: 73%

“…All these patients except one had an excellent prognosis, as described in another report. 5 Three of these cases were less than 10 year old, and the others were between 20 and 24 years old, our case being the oldest among the reported male cases. (The oldest female was 73.…”

Section: Discussionmentioning

confidence: 99%

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Secretory breast carcinoma in a 66 year old man.

1998

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A secretory carcinoma of the breast, associated with axillary node metastasis, unilateral gynaecomastia, and chronic active hepatitis, occurred in a 66 year old man. Although secretory carcinoma of the breast usually occurs in children and adult women, our case shows that it can rarely occur in the elderly male. (J Clin Pathol 1998;51:545-547) Keywords: breast; secretory carcinoma; gynaecomastia Secretory carcinoma of the breast is a rare neoplasm first described in children and called "juvenile carcinoma."1 Later it was also found in female adults, although the median age (the second decade) of secretory carcinoma of the breast is younger than that of the usual breast cancer.2 On the other hand, breast carcinoma is an uncommon neoplastic condition among men, accounting for no more than 1% of all breast carcinomas, 3 and to our knowledge only six secretory carcinomas of the breast have been reported, all in men less than 25 years of age.2 4-9 Here, we report a case of secretory carcinoma of the breast in a 66 year old man (the oldest known secretory carcinoma of the breast in a male) associated with axillary node metastasis, unilateral gynaecomastia, and chronic active hepatitis. Case reportA 66 year old Japanese man presented with a recently enlarging tumour in the subareolar region of the left breast. The tumour was noticed three years before and the clinical impression was of gynaecomastia as he had hepatitis C virus (HCV) positive chronic active hepatitis. At the ages of 62 and 65 years, he had had two operations for hepatocellular carcinoma. On the first occasion the histology was of poorly diVerentiated (sarcomatous) type, while on the second occasion it was of well differentiated (trabecular) type. At the time of the breast presentation, follow up examination of the liver showed a solitary tumour. Segmentectomy (S4) of the liver and removal of the breast tumour were performed simultaneously. Computed tomography and ultrasonography showed no other tumour anywhere in the body, including the thyroid. As the breast tumour showed infiltrative growth and tumour cells were present in the surgical margin, the patient had a modified radical mastectomy with axillary node dissection. The right breast had no tumour. The patient was free from local recurrence or metastases eight months after the surgery. Histological findingsThe breast tumour resected in the first operation was 3.0 × 3.0 × 2.6 cm, relatively circumscribed and markedly firm, with a greyishwhite cut surface. The tissues were fixed in 10% buVered formalin. Microscopically, the tumour was separated by hyalinising fibrosis and showed partial infiltration of the margin. The tumour cell arrangement was microcystic and papillary. Tumour cells and microcystic spaces contained abundant secretion, which usually stained pale pink with haematoxylin and eosin, and they mimicked thyroid follicles (fig 1).Immunohistochemistry was performed by the streptavidin-biotin method using the following antibodies: keratin, epithelial membrane antigen (EMA), lactalbu...

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“…3,5,6,9 The fact that 17 cases of juvenile secretory carcinoma of the breast have presented as asymptomatic swellings and none have given rise to nipple discharge, may support this recommendation. 15 Excisional biopsy should, as a general rule, be avoided, particularly in girls. Minimal injury to the breast bud, which measures at times only a few millimeters, may compromise subsequent breast development and result in significant permanent damage.…”

Section: 35-9mentioning

confidence: 99%

Bloody Nipple Discharge in a 4-Year Old Child

et al. 2003

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Breast enlargement is considered a physiologic event in male and female neonates. However, it is rarely encountered in infancy and is deemed unusual in young children beyond the first year of life.1,2 Breast enlargement along with bloody nipple discharge, first reported in 1983 3 appears to be even more uncommon in children. We report a case of a 4-year-old boy with a 2-week history of left breast enlargement with serosanguinous nipple discharge and ipsilateral palpable axillary lymph nodes. Case ReportA 4-year-old boy was referred to the pediatric surgical service after the mother presented her child with a history of bloody nipple discharge of one week duration to the emergency room physician. The mother noted blood stains initially on the boy's underwear and later saw blood coming out of the left nipple. There was no history of breast enlargement, pain or fever. Trauma and drug ingestion were denied. Physical examination revealed a healthy child with normal findings except for an ovoid mass measuring 2.5 x 1.5 centimeters above the left nipple. It was mobile, not attached to underlying structures or skin, firm, and not tender or hot. There was no erythema. Slight pressure on the mass instigated bloody discharge from the nipple (Figure 1). The left axilla revealed two enlarged lymph nodes, one measuring 0.5 centimeter, the other 2.0 centimeters in diameter. The right breast and axilla were normal. The testes were of normal size, configuration and consistency. The complete blood count, prothrombin time and partial thromboplastin time were normal. The breast mass, including the small nipple, were excised. Both axillary lymph nodes were removed as well.The frozen section proved to be a benign lesion. The paraffin section demonstrated many dilated ducts containing granular eosinophilic material and red blood cells. In some, there were many macrophages containing foamy granular material within the lumen and pronounced periductal fibrosis with a moderate chronic inflammatory reaction in the adjacent wall (Figure 2). An occasional dilated duct proved that focal ulceration was present. A section from the left nipple showed a few dilated ducts with similar microscopic changes. A section from the axillary lymph nodes illustrated sinus histiocytosis.

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Juvenile secretory carcinoma of the breast

Cited by 74 publications

References 4 publications

Secretory breast carcinoma: a clinicopathological and immunophenotypic study of 15 cases with a review of the literature

Secretory breast carcinoma: a clinicopathological and immunophenotypic study of 15 cases with a review of the literature

Secretory breast carcinoma in a 66 year old man.

Bloody Nipple Discharge in a 4-Year Old Child

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