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Secretory carcinoma of the breast in adults: are there well defined parameters for decision making?

Secretory carcinoma (SC) of the breast is an extremely rare neoplasm. SC of the breast was initially described in children and adolescents, but a relatively frequent number of cases have been reported in adults. SC of the breast is often associated with a very good prognosis, but in adults with larger tumours it may carry a more aggressive behaviour. The present case refers to a 62-year-old female with a progressively growing large breast tumour, during 16 years. Physical examination demonstrated extensive fixation of the tumour to skin with prominent inflammatory signs and areas of cutaneous necrosis. Initial treatment was a palliative mastectomy. Due to the histological diagnosis of secretory carcinoma, without skin invasion, the patient was then submitted to axillary dissection that disclosed metastasis in 2 out of 13 lymph nodes. The patient died 24 months after surgery without further treatment, due to dissemination of the disease. The present case corroborates the ominous prognosis of the secretory carcinoma in adults with large tumours (T2) and with lymph nodes metastasis (N1). The authors review the literature focusing on the prognostic factors for treatment decision of this rare type of breast carcinoma in adults.

Breast; Secretory carcinoma; Adult


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