Secretory Carcinoma of the Breast

Abstract

Objective. The purpose of this series was to evaluate the sonographic features of secretory carcinoma of the breast. Methods. Between 1994 and 2006, 9 patients had histologically confirmed secretory carcinoma of the breast in our institution, and 6 of them underwent breast sonography. We retrospectively evaluated the sonographic findings of the patients in correlation with other available images and reviewed the clinical records. Results. Clinical manifestations were a palpable mass (n = 3), a bloody nipple discharge (n = 1), and screening-detected abnormalities (n = 2). Breast sonograms showed masses with a round or oval (n = 5) or tubular (n = 1) shape, with relatively well-circumscribed (n = 2) or partially microlobulated (n = 4) margins, and with a hypoechoic (n = 4) or an isoechoic (n = 2) internal echo texture. Most lesions were single nodules (n = 3) or groups of nodules (n = 2) measuring 1 cm or smaller, except 1 mass measuring 3.5 cm with axillary lymph node metastasis. Two cases had associated ductectasia. Sonographic assessments were classified as Breast Imaging Reporting and Data System category 3 in 2 cases, category 4A in 3 cases, and category 4B in 1 case. Conclusions. Secretory carcinoma of the breast is frequently shown as a small benign-looking nodule or group of nodules or sometimes as an intraductal lesion with a low clinical stage on sonography. Although secretory carcinoma is a rare breast malignancy, awareness of its sonographic features will be helpful for the differential diagnosis.

Management of Unusual Histological Types of Breast Cancer

“…It represents 0.15% [16] of all breast cancers and 0.2% of male breast cancers [23]. The median age is 25-40 years [37][38][39], but it occurs earlier in males, at a median age of 17 years [23]. There are limited data relating to tumor size-the maximum size reported is 16 cm [38] and older patients tend to present with larger tumors [44].…”

“…In a review of the literature [37], staging was available in only 24 of 121 cases and six had metastatic disease. Nodal involvement occurs in 20%-30% of cases [23,24,39,75]. Secretory breast cancers demonstrate low Ki67 expression [38,68], are usually ER Ϫ PR Ϫ [37,38,45,68], and are predominantly HER-2 Ϫ [45,68].…”

“…There is some controversy about the optimal surgical approach [38]. Local recurrences occurred in 33% of cases treated with breast-conserving surgery in one series (n ϭ 12) [75], and some authors advocate mastectomy [38,39,45,78,106] with lymph node sampling [16,38,45,107] as the primary surgical approach. Alternatively, it may be possible to consider breast-conserving surgery [23,37,45,107,108] provided that there are generous margins [23,45].…”

“…Alternatively, it may be possible to consider breast-conserving surgery [23,37,45,107,108] provided that there are generous margins [23,45]. Surgery in children poses particular concerns for future breast development [45,78] and most advocate attempting to preserve the breast bud [38,39,78,106]. However, this may contribute to inadequate surgery and local recurrences [37,78].…”

A Case of a Secretory Carcinoma of the Breast: Radio-Pathological Correlation

“…Also, our case of mammography showed multiple iso-density masses with unclear and partly spiculated margin and this finding was not specific for the entity of a secretory carcinoma. On ultrasonography, secretory carcinoma of the breast is frequently shown as a small benign-looking nodule or group of nodules with low clinical stage 18 . And secretory carcinoma of ultrasonographic appearance is a solid, well-circumscribed mass and is not specific for this entity and mimics benign entities such as fibroadenoma, as well as other well-differentiated breast carcinomas 19 .…”