Secretory Carcinoma Of Breast Research Articles

Secretory Breast Carcinoma, a Case Report and Literature Review

Secretory breast carcinoma (SBC) is a very rare subtype of breast carcinoma that reported mostly in young women, with a median age of 25 years. Despite the low frequency, SBC elicits pathologic interest because of their unique morphology and excellent prognosis. Authors report a 23-year-old woman presented with a nodule in retro areolar region of her right breast. Microbiopsic examination revealed neoplastic tissue. Pathological examination of tumor revealed SBC. This tumor is morphologically characterized by the presence of abundant eosinophilic secretions in intracellular vacuoles and intercellular spaces. The objective of this paper is to review the epidemiological, clinical, paraclinical and therapeutic aspects of SBC from a case report and literature review.

A Case of Mammary-Analogue Secretory Carcinoma of the Parotid Gland

Salivary gland carcinoma was originally classified as acinic cell carcinoma because of its histological similarity to secretory breast carcinoma. However, in 2010, Skalove et al. characterized this tumor as mammary-analogue secretory carcinoma, because like secretory breast carcinoma, it often expresses the ETV6-NTRK3 fusion oncogene. We encountered a case of mammary-analogue secretory carcinoma arising from the parotid gland. This specific diagnosis was made because (1) a follicular variant was present, (2) physaliphorous cells were observed, (3) no zymogen granules were observed, (4) the mucoid discharge in the follicular lumen was D-PAS-positive, and (5) the tumor showed immunostaining characteristics consistent with those of mammary-analogue secretory carcinoma (e.g., positive for S-100 and adipophilin). No additional treatment was administered to the patient after the resection, as the tumor is known to show a low malignancy potential and the surgical margins were negative. Tumor recurrence or metastasis has not been observed until date.

Secretory carcinoma of breast in adult patient with sentinel lymph node metastasis

Secretory carcinoma of breast in adult patient with sentinel lymph node metastasis

Mammary Analogue Secretory Carcinoma (MASC) of the salivary gland: A new tumor entity.

Mammary analogue secretory carcinoma (MASC) is a recently described low-grade malignant tumor of the salivary glands, biologically and morphologically equivalent to secretory breast carcinoma. We give a brief overview of this new entity, including morphological, immunohistochemical, molecular-genetic, clinical, epidemiologic features, differential diagnosis, and outcome results.

Mammary analogue secretory carcinoma of salivary glands: a clinicopathologic study of 11 cases.

Mammary analogue secretory carcinoma (MASC) is a recently described tumor sharing the histologic, immunohistochemical, and molecular profile of secretory carcinoma of breast. We aimed to evaluate the morphologic and histochemical features needed/required for the diagnosis of MASC without adjunct of molecular analysis. Six retrospective cases suspicious for MASC and 5 prospective cases reported as MASC were included in the study. Molecular analysis of ETV6 by fluorescence in situ hybridization was performed at the University of Pittsburg, USA. The ages of the patients ranged from 9 to 60 years (mean, 27.5 years). Histologically, all tumors showed mixed growth patterns including microcystic, macrocystic, papillary, tubular, and solid, papillary the being most common pattern. The tumor cells showed round to oval vesicular nuclei with small nucleoli, and eosinophilic to vacuolated cytoplasm. All cases demonstrated luminal and cytoplasmic mucin on periodic acid-Schiff with and without diastase digestion and alcian blue stain. ETV6 fusion gene rearrangement by fluorescence in situ hybridization was detected in 10 of 11 tumors. Recurrences occurred in 3 patients, and 1 patient died of disease 5 years after surgery. In conclusion, MASC is a relatively rare salivary gland malignancy exhibiting distinct histologic and histochemical features which can help to differentiate it from other mimics. Histologically, papillary-cystic and microcystic patterns are the main clues to diagnosis. The follicular pattern of acinic cell carcinoma might represent MASC, as 4 cases in our series had this pattern. Two patients in our series were 9 and 9½ years old respectively, which are the youngest ages ever recorded for MASC.

Secretory Breast Carcinoma: A Histopathologic and Genomic Spectrum Characterized by a Joint Specific ETV6-NTRK3 Gene Fusion.

Secretory breast carcinoma (SBC) is a rare breast carcinoma with distinctive morphologic features and a recurrent specific chromosomal translocation t(12;15)(p13;q25), usually of low histologic grade and favorable prognosis. We describe the morphologic and genetic characteristics of 11 cases of SBC from 10 patients. Histologic and immunohistochemical analyses, fluorescence in situ hybridization using break-apart probes specific to ETV6 on 12p13, reverse transcription polymerase chain reaction with in-house probes specific to the ETV6-NTRK3 gene fusion, and DNA copy number variation by array comparative genomic hybridization analyses were performed on all cases. Seven cases were of low histologic grade, 3 were intermediate, and 1 had high-grade nuclear atypia, necrosis, and numerous mitoses. This patient had a fatal outcome. Five cases displayed low hormonal receptor expression, whereas the rest had basal-type immunoprofiles. All interpretable cases harbored an ETV6-NTRK3 gene fusion by reverse transcription polymerase chain reaction and/or an ETV6 rearrangement by fluorescence in situ hybridization, with duplication of the oncogenic derivative in 2 cases. Array comparative genomic hybridization analysis showed simplex genomic profiles. The 2 cases with ETV6-NTRK3 duplication included a gain of 12p starting from the ETV6 locus to the telomere, associated with a gain of the 15q from the centromere to NTRK3 in 1 case, and in the other a normal profile up to NTRK3 on 15q, and then a loss up to the telomere, suggesting loss of corresponding normal chromosome 15. These findings provide a novel insight into the morphologic and genetic spectrum of SBC, ranging from low-grade to high-grade histology, with occasional low hormonal receptor expression, simplex genomic profiles, and possible unfavorable course.

Secretory carcinoma of breast mimicking an abscess: A diagnostic dilemma

Secretory carcinoma is a rare type of breast carcinoma usually seen in the young females, and it is also called as Juvenile carcinoma. We report here a case of secretory carcinoma in an elderly female with an unusual clinical presentation. She had a painful swelling in left breast of 6 cm × 5 cm size for the past 6 months. Skin over the swelling was inflamed and ulcerated. Mammogram findings favored a chronic infected hematoma/abscess. Fine needle aspirate (FNA) is a murky fluid admixed with blood and was reported as acute inflammatory lesion. 2 weeks later she developed nipple retraction and an increase in size of the swelling. Fine needle aspiration cytology (FNAC) was repeated again from firm areas and in multiple points of swelling. To our surprise, FNA smears revealed dysplastic ductal epithelial cells with minimal atypia. Modified radical mastectomy was planned. Histopathological examination confirmed the mass as secretory carcinoma, a rare variant of ductal carcinoma of the breast. Postoperative chemotherapy and radiotherapy was started. We report this case to emphasize that FNAC can be repeated in suspicious cases and should be correlated clinico-radiologically to give a preoperative diagnosis.

Secretory carcinoma of breast in a patient treated for differentiated thyroid carcinoma-a diagnostic dilemma.

Secretory carcinoma of the breast is a rare entity accounting for less than 1% of all infiltrating breast carcinomas. Though initially considered as "juvenile breast carcinoma", due to its occurrence predominantly in pediatric population, it was later found to present in other age groups as well. We report a case of secretory carcinoma breast in a middle aged woman who had undergone treatment for papillary carcinoma of thyroid previously. The uniqueness of this malignancy and the diagnostic dilemma due to patient's past medical history, are discussed in detail.

Secretory breast carcinoma in a 12-year-old girl: A case report.

Secretory breast carcinoma (SBC) is a rare tumor that was originally described in children and adolescent women, with a characteristic morphology and controversy regarding the choice of treatment. This unusual breast cancer subtype generally has a favorable prognosis, although several cases have been described in adults with increased tumor aggressiveness and a risk of metastases. Surgery is considered the most appropriate treatment for this pathology. The present study describes the case of a 12-year-old female who presented with a painless lump in the left breast, and subsequently underwent a biopsy of the sentinel lymph node and a partial resection of the left breast (breast-conserving therapy). Periodic follow-up examinations after completion of the surgical and chemotherapeutic treatment have shown no evidence of either local regression or distant metastases and, one year later, the patient remains free of the disease. This study suggests that local excision with sentinel lymph node mapping may be a suitable therapeutic approach for children with SBC

Secretory breast carcinoma: A report of three cases and a review of the literature.

Secretory breast carcinoma is a very rare and distinct subtype of breast cancer, characterized by the presence of intracellular and extracellular secretory material. Secretory breast carcinoma has a good clinical outcome and systemic involvement is rare. The majority of studies of this tumor have been case reports or separate analyses, and due to the rarity of these tumors, it has been difficult to fully elucidate their characteristics and define optimal treatment strategies. To add to the current knowledge of secretory breast carcinoma, the present study reports three cases of secretory breast carcinoma in patients of different ages, and with different hormone receptor statuses and treatment methods. The present study identified that each patient with secretory breast carcinoma may present with different symptoms and clinical characteristics. Therefore, therapeutic options should be selected based on the overall status of the patient and the characteristics of this rare disease.

Diagnostic dilemma of FNA diagnosis of secretory carcinoma of breast

Secretory carcinoma (SC) is one of the least common types of breast carcinoma. The tumor has distinctive histologic features with prominent secretory activity similar to lactational change and minimal nuclear atypia. As the cytomorphologic features of SC overlaps benign breast lesions with lactational change and apocrine change, the initial diagnosis of SC may be missed on cytology in some cases. A 29-year-old woman presented with a lump in the left breast since 9 months. The fine needle aspiration cytology (FNAC) suggested proliferative breast disease without atypia. Excision biopsy showed secretory carcinoma. The case is presented to highlight the cytologic features of SC, which may overlap with lactational change and apocrine change.

ETV6–NTRK3 as a therapeutic target of small molecule inhibitor PKC412

The ETV6–NTRK3 (EN) fusion gene which encodes a chimeric tyrosine kinase was first identified by cloning of the t(12;15)(p13;q25) translocation in congenital fibrosarcoma (CFS). Since then, EN has been also found in congenital mesoblastic nephroma (CMN), secretory breast carcinoma (SBC) and acute myelogenous leukemia (AML). Using IMS-M2 and M0–91 cell lines harboring the EN fusion gene, and Ba/F3 cells stably transfected with EN, we demonstrated that PKC412, also known as midostaurin, is an inhibitor of EN. Inhibition of EN activity by PKC412 suppressed the activity of it downstream molecules leading to inhibition of cell proliferation and induction of apoptosis. Our data for the first time suggested that PKC412 could serve as therapeutic drug for treatment of patients with this fusion.

ETV6 Disruption Does Not Predict Indolent Clinical Behavior in Secretory Breast Carcinoma

ETV6 Disruption Does Not Predict Indolent Clinical Behavior in Secretory Breast Carcinoma

Apport des analyses moléculaires à la classification anatomopathologique des sarcomes

Conventional histology and immunohistochemistry remain the basic tools for the diagnosis and classification of sarcomas. However, molecular biology can enrich the pathologists analysis: the identification of a specific molecular abnormality can confirm diagnosis, rule out a differential diagnosis, and sometimes provide prognostic information. About 15% of sarcomas bear a specific translocation, such as rearrangements of SS18 (SYT) [synovial sarcoma], DDIT3 (CHOP) [myxoid liposarcoma], FUS (TLS) [low-grade fibromyxoid sarcoma, myxoid liposarcoma], FOXO1 (FHKR) [alveolar rhabdomyosarcoma], PDGFB (dermatofibrosarcoma protuberans), and ALK (inflammatory myofibroblastic tumor). Rearrangements of the EWSR1 gene are less specific as found in many sarcomas (Ewing sarcoma, desmoplastic round cell tumor, clear cell sarcoma, myxoid liposarcoma, andmyoepithelioma). The search for an amplification of MDM2 gene is a sensitive and specific tool for the diagnosis of atypical lipomatous tumors/welldifferentiated liposarcomas and dedifferentiated liposarcomas (ALT/WDL). The same molecular abnormality can be observed in several tumor types, emphasizing the importance of integrating the results of any molecular study within clinical, morphological, and immunohistochemical context: ASPSCR1 (ASPL)-TFE3 translocation can be observed in alveolar soft tissue sarcoma but also in juvenile renal carcinomas, ETV6 (TEL)-NTRK3 (TRKC) translocation in infantile fibrosarcoma and secretory breast carcinoma, ALK rearrangements in inflammatory myofibroblastic tumors, anaplastic lymphomas, and lung adenocarcinomas. In some cases immunochemistry can highlight the consequence of a molecular abnormality: MDM2 overexpression in ALT/WDL, loss of INI1 expression in rhabdoid tumors and epithelioid sarcoma, and overexpression of ALK in inflammatory myofibroblastic tumors.

Secretory carcinoma of breast: clinicopathologic study of 8 cases

Our aim was to describe clinicopathologic features of secretory carcinoma on a cohort of cases. We retrieved reported cases of secretory carcinoma of breast (SCB) in the Section of Histopathology, Department of Pathology & Microbiology, Aga Khan University Hospital Karachi, from May 2004 to December 2011. The slides were reviewed, and clinicopathologic features were noted. A total of 8 cases of SCB were found. The age ranged from 17 to 60 years (median, 41 years) with a female to male ratio of 7:1. Lumpectomy was done in 6 cases, and mastectomy, in 2 cases. The tumor size ranged from 2.5 to 10 cm (mean, 5.5 cm). Histologically, abundant extra- and intracellular secretory material was seen in all cases. Most of the tumors showed mixtures of patterns with dominant microcystic and papillary patterns. In situ component was seen in only 1 case. Lymph node metastases were seen in both cases with lymph node sampling. In conclusion, SCB is a rare type of ductal breast carcinoma. The papillary pattern of SCB is rare according to published data but was seen in most of our cases. In situ secretory carcinoma is even rarer, and to date, we have seen a single case only. Although most occur in women, these can be seen in men as well.

Secretory Carcinoma of Breast Demonstrates Nuclear or Cytoplasmic Expression in p63 Immunohistochemistry

The aim of this study was to evaluate the pattern of p63 expression and its implication in secretory carcinoma of the breast. Immunohistochemical staining for p63, p53, MDM2, and smooth muscle actin was performed in 7 cases of secretory carcinomas. Nuclear expression of p63 was observed in 3 cases, whereas staining against cytoplasmic and intraluminal secretory material were observed in 4 cases. p53 was expressed in 3 cases and MDM2 in 2 cases. The loss of myoepithelial cells was confirmed by immunohistochemical stain for smooth muscle actin in invasive secretory carcinomas. The pattern of expression of p63 in secretory carcinoma of the breast was revealed in nuclei or cytoplasm/secretory materials.

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

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.

Cytodiagnosis of secretory carcinoma of the breast

Secretory carcinoma is a rare form of breast carcinoma which has a predilection for juveniles and young adults (usually less than 30 years of age), becoming progressively less common with advancing age. It is a low grade breast carcinoma which shows distinct features at histology. Diagnosis of this carcinoma on fine needle aspiration cytology (FNAC) is difficult. We report a case of a 62-year-old woman diagnosed to have secretory carcinoma of breast on FNAC. Histopathological examination confirmed the diagnosis. The recognition of secretory carcinoma is important because the cytological findings can be confused with those of lactating breast. Preoperative diagnosis is essential for appropriate surgical therapy. Secretory carcinoma is reported to have good prognosis, but surgical therapy with an axillary node dissection is recommended, since axillary metastases have been found in approximately 30% of the recorded cases.

Secretory Breast Carcinoma: Unique, Triple-Negative Carcinoma With a Favorable Prognosis and Characteristic Molecular Expression

Secretory carcinoma is a rare but distinct subtype of breast carcinoma, with characteristic histomorphology and generally favorable prognosis. Although it was originally described as a juvenile breast carcinoma, occurring in young children, most cases have been reported in adults of both sexes. As the name implies, the characteristic histomorphology is the presence of a large amount of intracellular and extracellular, eosinophilic secretion material that stains positive for periodic acid-Schiff. Most tumors stain positive for S100 and negative for estrogen receptor, progesterone receptor, and ERBB2 (formerly HER2/neu) (ie, triple negative). In addition, some secretory carcinomas demonstrate a basal-like immunoprofile. Recent studies have shown the characteristic molecular feature: a balanced translocation t(12;15), resulting in an ETS variant 6-neurotrophic tyrosine kinase receptor type 3 (ETV6-NTRK3) fusion gene encoding a chimeric tyrosine kinase. Although rare events of axillary lymph node or distant metastases have been documented, the prognosis is generally excellent. The methods of surgical treatment and the role of adjuvant therapy, particularly for young patients, remain controversial.

Case report and review of the literature: Secretory breast cancer in a 13-year-old boy—10 years of follow up

Carcinoma of the breast is very rare in childhood, accounting for less than 1% of all childhood malignancies and is especially rare in boys. Delay in diagnosis and treatment in children with breast cancer may occur because surgeons are very reluctant to perform biopsies on the developing breast, since these can cause future deformity. We report a case of male secretory breast carcinoma in a 13-year-old boy. Radical mastectomy was performed followed by chemotherapy. The patient is free of disease after 10 years. Secretory breast carcinoma (SBC) is the commonest type of breast carcinoma in children. In this article, we discuss the diagnosis and treatment options for breast cancer among children as well as features of SBC, based on a literature review.