Autopsy and Case Reports
https://autopsyandcasereports.org/article/doi/10.4322/acr.2020.227
Autopsy and Case Reports
Clinical Case Report

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

Nirmalya Banerjee; Devmalya Banerjee; Neha Choudhary

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Abstract

ABSTRACT: Secretory carcinoma of the breast (SBC) is a rare breast neoplasm. Most of the patients present at an early stage with a relatively indolent clinical course. Lymph node and distant metastasis are also very infrequent. The histomorphological features of the secretory breast carcinoma are quite characteristic. Predominantly three histological patterns, solid, microcystic, and tubular, have been noted with copious amounts of intra and extracellular secretory material. Most commonly, no positivity for estrogen receptor (ER), progesterone receptor (PR) and ERBB2(HER2/neu) is observed in SBCs. As SBC can occasionally be hormone receptor-positive, they should not be categorized in the triple-negative breast carcinoma (TNBC) group in general. A very characteristic genetic translocation t (12;15) has been noted in this rare tumor, resulting in a fusion between ETV6 and NTRK3 proteins. We present a case of a 60-year-old lady who presented with right breast lump of 1-month duration and was managed by lumpectomy and sentinel lymph node dissection. Axillary dissection was not performed because the sentinel lymph node biopsy was negative. Postoperative radiotherapy was given to the right breast with a boost to the tumor bed. No adjuvant chemotherapy was given No recurrence has been noted even after a year of the completion of treatment

Keywords

Breast neoplasm, Secretory component, Sentinel lymph node biopsy, Translocation, genetic

References

1 McDivitt RW, Stewart FW. Breast carcinoma in children. JAMA. 1966;195(5):388-90. http://dx.doi.org/10.1001/jama.1966.03100050096033. PMid:4285563.

2 Horowitz DP, Sharma CS, Connolly E, Gidea-Addeo D, Deutsch I. Secretory carcinoma of the breast: results from the survival, epidemiology and end results database. Breast. 2012;21(3):350-3. http://dx.doi.org/10.1016/j.breast.2012.02.013. PMid:22494666.

3 Li D, Xiao X, Yang W, et al. Secretory breast carcinoma: a clinicopathological and immunophenotypic study of 15 cases with a review of the literature. Mod Pathol. 2012;25(4):567-75. http://dx.doi.org/10.1038/modpathol.2011.190. PMid:22157932.

4 Laé M, Fréneaux P, Sastre-Garau X, Chouchane O, Sigal-Zafrani B, Vincent-Salomon A. Secretory breast carcinomas with ETV6-NTRK3 fusion gene belong to the basal-like carcinoma spectrum. Mod Pathol. 2009;22(2):291-8. http://dx.doi.org/10.1038/modpathol.2008.184. PMid:19011601.

5 Vasudev P, Onuma K. Secretory breast carcinoma: unique, triple-negative carcinoma with a favorable prognosis and characteristic molecular expression. Arch Pathol Lab Med. 2011;135(12):1606-10. http://dx.doi.org/10.5858/arpa.2010-0351-RS. PMid:22129193.

6 Kozioł M, Püsküllüoglu M, Zygulska A. PARP inhibitors and their role in the therapy of triple-negative metastatic breast cancer. Przegl Lek. 2012;69(6):256-70. PMid:23094440.

7 Perou CM, Sørlie T, Eisen MB, et al. Molecular portraits of human breast tumours. Nature. 2000;406(6797):747-52. http://dx.doi.org/10.1038/35021093. PMid:10963602.

8 Yehiely F, Moyano JV, Evans JR, Nielsen TO, Cryns VL. Deconstructing the molecular portrait of basal-like breast cancer. Trends Mol Med. 2006;12(11):537-44. http://dx.doi.org/10.1016/j.molmed.2006.09.004. PMid:17011236.

9 Pareja F, Geyer FC, Marchiò C, Burke KA, Weigelt B, Reis-Filho JS. Triple-negative breast cancer: the importance of molecular and histologic subtyping, and recognition of low-grade variants. NPJ Breast Cancer. 2016;2(1):1603. http://dx.doi.org/10.1038/npjbcancer.2016.36. PMid:28721389.

10 Tognon C, Knezevich SR, Huntsman D, et al. Expression of the ETV6-NTRK3 gene fusion as a primary event in human secretory breast carcinoma. Cancer Cell. 2002;2(5):367-76. http://dx.doi.org/10.1016/S1535-6108(02)00180-0. PMid:12450792.

11 Wolff AC, Hammond ME, Hicks DG, et al. Recommendations for human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists clinical practice guideline update. J Clin Oncol. 2013;31(31):3997-4013. http://dx.doi.org/10.1200/JCO.2013.50.9984. PMid:24101045.

12 Lijuan L, Nan W, Fangxuan L, Lingmei L, Lijuan W, Juntian L. Clinicopathologic and molecular characteristics of 44 patients with pure secretory breast carcinoma. Cancer Biol Med. 2019;16(1):139-46. http://dx.doi.org/10.20892/j.issn.2095-3941.2018.0035. PMid:31119054.

13 Jacob JD, Hodge C, Franko J, Pezzi CM, Goldman CD, Klimberg VS. Rare breast cancer: 246 invasive secretory carcinomas from the National Cancer Data Base. J Surg Oncol. 2016;113(7):721-5. http://dx.doi.org/10.1002/jso.24241. PMid:27040042.

14 Amott DH, Masters R, Moore S. Secretory carcinoma of the breast. Breast J. 2006;12(2):183. http://dx.doi.org/10.1111/j.1075-122X.2006.00233.x. PMid:16509851.

15 Rosen PP, Cranor ML. Secretory carcinoma of the breast. Arch Pathol Lab Med. 1991;115(2):141-4. PMid:1992979.

16 Soyer T, Yaman Bajin İ, Orhan D, et al. Secretory breast carcinoma in a 6-year-old girl: mastectomy with sentinel lymph node dissection. Pediatr Surg Int. 2015;31(7):677-81. http://dx.doi.org/10.1007/s00383-015-3721-0. PMid:25994562.

17 Garlick JW, Olson KA, Downs-Kelly E, Bucher BT, Matsen CB. Secretory breast carcinoma in an 8-year-old girl: A case report and literature review. Breast J. 2018;24(6):1055-61. http://dx.doi.org/10.1111/tbj.13126. PMid:30251458.

18 Din NU, Idrees R, Fatima S, Kayani N. Secretory carcinoma of breast: clinicopathologic study of 8 cases. Ann Diagn Pathol. 2013;17(1):54-7. http://dx.doi.org/10.1016/j.anndiagpath.2012.06.001. PMid:22832018.

19 Tognon C, Gamett M, Kenward E, Kay R, Morrison K, Sorensen PH. The chimeric protein tyrosine kinase ETV6-NTRK3 requires both Ras-Erk1/2 and PI3- kinase-Akt signaling for fibroblast transformation. Cancer Res. 2001;61(24):8909-16. PMid:11751416.

20 Strauss BL, Bratthauer GL, Tavassoli FA. STAT 5a expression in the breast is maintained in secretory carcinoma, in contrast to other histologic types. Hum Pathol. 2006;37(5):586-92. http://dx.doi.org/10.1016/j.humpath.2006.01.009. PMid:16647957.

21 Cocco E, Scaltriti M, Drilon A. NTRK fusion-positive cancers and TRK inhibitor therapy. Nat Rev Clin Oncol. 2018;15(12):731-47. http://dx.doi.org/10.1038/s41571-018-0113-0. PMid:30333516.

22 Drilon A, Laetsch TW, Kummar S, et al. Efficacy of Larotrectinib in TRK Fusion-Positive Cancers in Adults and Children. N Engl J Med. 2018;378(8):731-9. http://dx.doi.org/10.1056/NEJMoa1714448. PMid:29466156.

23 Drilon A, Siena S, Ou SI, et al. Safety and Antitumor Activity of the Multitargeted Pan-TRK, ROS1, and ALK Inhibitor Entrectinib: Combined Results from Two Phase I Trials (ALKA-372-001 and STARTRK-1). Cancer Discov. 2017;7(4):400-9. http://dx.doi.org/10.1158/2159-8290.CD-16-1237. PMid:28183697.

24 Vasudev P, Onuma K. Secretory breast carcinoma: unique, triple-negative carcinoma with a favorable prognosis and characteristic molecular expression. Arch Pathol Lab Med. 2011;135(12):1606-10. http://dx.doi.org/10.5858/arpa.2010-0351-RS. PMid:22129193.

25 Lee SG, Jung SP, Lee HY, et al. Secretory breast carcinoma: A report of three cases and a review of the literature. Oncol Lett. 2014;8(2):683-6. http://dx.doi.org/10.3892/ol.2014.2213. PMid:25009650.

26 Herz H, Cooke B, Goldstein D. Metastatic secretory breast cancer. Non-responsiveness to chemotherapy: case report and review of the literature. Ann Oncol. 2000;11(10):1343-7. http://dx.doi.org/10.1023/A:1008387800525. PMid:11106125.
 


Submitted date:
05/30/2020

Accepted date:
08/12/2020

Publication date:
12/08/2020

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