Secretory breast carcinoma in an 8-year-old girl: A case report and literature review

Abstract

Secretory breast carcinoma (SBC) is a rare form of breast cancer found in both children and adults, and is the most common breast cancer in the pediatric population.Although SBC usually carries a favorable prognosis, there have been reported cases of axillary and distant metastases. Surgery is the primary mode of treatment, however, there exists variability within the literature surrounding the management of SBC. We report a case of an 8-year-old girl who presented with a firm, mobile, palpable breast mass. Ultrasonography was performed, followed by local excision, with surgical pathology concerning for SBC. The patient was definitively treated with mastectomy and sentinel lymph node (SLN) biopsy. She received no adjuvant therapies and 2 years later, remains disease free. Herein, we review the literature, curate data from 89 reported cases of pediatric and adult SBC, and address some of the controversy surrounding its treatment. From this review we conclude that patients with SBC should be reviewed at multidisciplinary treatment planning conference, undergo surgery with mastectomy or lumpectomy with SLN biopsy, and have longterm postoperative follow-up. K E Y W O R D Sbreast cancer, pediatric breast cancer, secretory breast carcinoma

Secretory carcinoma of the breast: clinicopathologic profile of 14 cases emphasising distant metastatic potential

“…[39][40][41][42] In their review of the literature, Garlick et al found that of the 44 cases of secretory carcinoma of the breast wherein IHC for hormone receptors were performed, eight of 44 (18%) of cases were ER positive, six of whom were men. 22 The group found no apparent association with ER positivity and age, tumour size, metastases or clinical outcome in these cases. In their immunohistochemical and genomic review of secretory carcinoma of the breast and mammary analogue secretory carcinoma, Krings et al reported 44% of their SCB cases (four of nine tumours) demonstrated weak to moderate ER expression.…”

“…In their review of the literature, Garlick et al . found that of the 44 cases of secretory carcinoma of the breast wherein IHC for hormone receptors were performed, eight of 44 (18%) of cases were ER positive, six of whom were men . The group found no apparent association with ER positivity and age, tumour size, metastases or clinical outcome in these cases.…”

“…Identification of a recurrent chromosomal rearrangement in secretory carcinoma, t(12;15)(p13;q25), resulting in a fusion between E26 transformation‐specific translocation variant 6 ( ETV6 ) and neurotrophic receptor tyrosine kinase 3 ( NTK3 ), allowed for a potentially targeted approach to management . This fusion has thus far been reported in 95.2% (40 of 42) of the cases tested in the literature …”

“…21 This fusion has thus far been reported in 95.2% (40 of 42) of the cases tested in the literature. 14,[21][22][23][24][25][26][27][28][29][30] Here, we sought to characterise the clinical, pathological and molecular features of this unusual, typically indolent subtype of breast cancer further, with a focus on particularly aggressive clinical courses through a review of cases diagnosed and managed in a single large tertiary cancer centre during a period of 25 years.…”

Secretory carcinoma of the breast, commonly exhibits the features of low grade, triple negative breast carcinoma- A Case report with updated review of literature

“…In the present case also, the tumor was located in the subareolar region which can be explained by the smaller relative size of the breast mound in younger patients deep to the nipple-areola complex. [15][16][17] Mammographic findings of SBC closely mimic a fibroadenoma as this carcinoma appears as a solitary, discrete lesion with a well-delineated margin. Since this carcinoma is more common in young girls, mammography always has diagnostic limitations because of the denser and glandular elements in the young breast.…”