Secretory breast carcinoma in adulthood: A case report with literature review

Abstract

Introduction. Secretory breast carcinoma is rare subtype of breast carcinoma which occurs primarily in children and young adults, so in the past it was called juvenile carcinoma. Case report. A 67-year-old female patient presented with mass of the right breast since one month. After physical, routine laboratory examination and mammography, core needle biopsy was performed and histopathological examination confirmed invasive carcinoma. Immunohistochemically, estrogen-receptors (ER) and progesteron-receptors (PR) showed weak positive reaction in 10% of tumor cells, while human epidermal growth factor receptor-2 (HER-2) was without expression. After an adequate preoperative preparation, operation was done -quadrantectomy with sentinel lymph node biopsy. Postoperatively, the patient was treated with 6 cycles of cyclophosphamide, methotrexate and fluorouracil (CMF) combination, radiotherapy (60 Gy) and tamoxifen. After 5-year follow-up the patient had no signs of the disease. Conclusion. Secretory breast cancer is a rare subtype of invasive breast carcinoma with wide age range of occurrence and good prognosis despite its triplenegative immunophenotype. Although the therapeutic management is non-consensual for this breast cancer special type, surgery is considered the mainstay of the treatment as well as the adjuvant chemotherapy and radiation.Key words: breast neoplasms; secretory breast carcinoma; triple negative breast neoplasms; diagnosis; mastectomy, segmental; adult. ApstraktUvod. Sekretorni karcinom dojke je redak tip karcinoma dojke koji se prvenstveno javlja kod dece i mlađih odraslih osoba, zbog čega se u prošlosti nazivao juvenilnim karcinomom. Prikaz bolesnika. Žena, starosti 67 godina, javila se zbog palpabilne, bezbolne mase u desnoj dojci, koja se javila mesec dana pre prijema. Nakon fizikalnog pregleda, rutinskih laboratorijskih analiza i mamografije, načinjena je iglena biopsija i patohistološkom analizom dijagnostikovan je invazivni karcinom dojke. Imunohistohemijski, 10% tumorskih ćelija je pokazalo slabu pozitivnost na estrogenske i progesteronske receptore, dok je receptor humanog epidermalnog faktora rasta-2 (HER-2) bio negativan. Posle adekvatne preoperativne pripreme, izvršen je opertivni zahvatkvadrantektomija sa biopsijom limfnog čvora stražara. Postoperativno, bolesnik je tertiran kombinacijom ciklofosfamid/metrotreksat/fluorouracil (6 ciklusa), radioterapijom (60 Gy) i tamoksifenom. Petogodišnjim praćenjem bolesnice nisu ustanovljeni znaci bolesti. Zaključak. Sekretorni karcinom dojke je redak tip karcinoma dojke, koji zahvata sve starosne grupe i ima dobru prognozu bez obzira na karakteristični tripl-negativni fenotip. Iako ne postoji standardizovan protokol lečenja, hirurška resekcija uz adjuvantnu hemoterapiju i zračnu terapiju su glavni terapijski postupci za ovaj tip karcinoma dojke.