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

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          Abstract

          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

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          Most cited references30

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          Secretory carcinoma of the breast.

          Nineteen examples of a very rare type of carcinoma of the breast have been studied. The carcinoma is unusual in that it has exaggerated secretory features previously reported only (with one exception) in juveniles. But not all the patients in our series were juveniles; they ranged in age from 9 to 69 years (median age, 25 years). Six were 30 years of age or older. Eighteen patients were female and 1 was a 9-year-old boy. Treatment varied from local excision of the tumor to radical mastectomy. Four of the 11 patients who had axillary node dissection had metastatic deposits showing the same secretory features as the primary neoplasm. One of these 4 patients, a 25-year-old woman, died within ten months with disseminated tumor. Because this distinctive pattern of carcinoma is not limited to children and adolescents, we propose that it be called "secretory carcinoma." Since, of the 19 patients, 4 (21%) had axillary node metastases and 1 (5%) died with disseminated tumor, an extended simple mastectomy is recommended as the initial treatment for patients more than 20 years of age.
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            Potential options for preservation of fertility in women.

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              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.
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                Author and article information

                Journal
                Oncol Lett
                Oncol Lett
                OL
                Oncology Letters
                D.A. Spandidos
                1792-1074
                1792-1082
                October 2014
                24 July 2014
                24 July 2014
                : 8
                : 4
                : 1635-1637
                Affiliations
                [1 ]Department of Breast Cancer Surgery, Tangshan People’s Hospital, Tangshan, Tangshan, Hebei 063001, P.R. China
                [2 ]Graduate Department, Hebei United University, Tangshan, Tangshan, Hebei 063001, P.R. China
                [3 ]Central Laboratory, Cancer Institute, Tangshan People’s Hospital, Tangshan, Tangshan, Hebei 063001, P.R. China
                [4 ]Department of Pathology, Tangshan People’s Hospital, Tangshan, Tangshan, Hebei 063001, P.R. China
                [5 ]Department of Gastrointestinal Tumor Surgery, Tangshan People’s Hospital, Tangshan, Tangshan, Hebei 063001, P.R. China
                [6 ]Breast Disease Prevention and Control Center, Tangshan, Tangshan, Hebei 063001, P.R. China
                Author notes
                Correspondence to: Dr Jing-Hua Zhang, Department of Breast Cancer Surgery, Tangshan People’s Hospital, 65 Shengli Road, Tangshan, Hebei 063001, P.R. China, E-mail: jinghuazhang2014@ 123456163.com
                [*]

                Contributed equally

                Article
                ol-08-04-1635
                10.3892/ol.2014.2380
                4156222
                25202382
                a3959cb9-eccb-46e2-ae37-c2c7356ef9b5
                Copyright © 2014, Spandidos Publications

                This is an open-access article licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License. The article may be redistributed, reproduced, and reused for non-commercial purposes, provided the original source is properly cited.

                History
                : 20 January 2014
                : 13 June 2014
                Categories
                Articles

                Oncology & Radiotherapy
                juvenile/secretory breast cancer,breast-conserving therapy,triple-negative carcinoma,a biopsy of the sentinel lymph node

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