Advancement of secretory breast carcinoma: a narrative review

Abstract

Background and Objective: Secretory breast carcinoma (SBC) is a rare breast malignancy. Most available studies on SBC are case reports or small case series, and the few large-sample studies available lack critical information due to database limitations. To improve the understanding of SBC and provide a reference for clinical practice, we systematically reviewed the demographic, clinical, pathologic, and genetic characteristics of SBC, as well as its treatment and prognosis.Methods: We conducted a PubMed search with the keywords "secretory breast carcinoma" or "juvenile breast carcinoma". Relevant English-language publications published from January 1966 to February 2022 were screened manually at 3 levels-title, abstract, and full text-to identify the articles that presented the demographic, clinical, pathologic, and genetic characteristics of SBC, as well as its treatment and prognosis.Key Content and Findings: SBC lacks specific clinical manifestations and has typical pathological and molecular characteristics, including intracellular and extracellular eosinophilic secretions, immune spectrum similar to hormone receptor-positive tumors, and the ETV6-NTRK3 fusion gene. Surgery remains the primary treatment for SBC. Postoperative radiotherapy is recommended by most researchers for adult SBC but not for pediatric patients. The evidence of chemotherapy and endocrine therapy is insufficient, and targeted therapy of the ETV6-NTRK3 fusion gene shows a good response. Most patients with SBC have a good prognosis except for a few patients who experience distant metastases. Future studies will be focused on the molecular characteristics of those patients with SBC who have a poor prognosis. Conclusions:The development of histopathology and molecular genetics has promoted the progress of the clinical diagnosis of SBC. The purpose of this review is to serve as a guide for the better clinical treatment of SBC, particularly in the areas of disease identification and prognosis classification for patients.

Secretory breast cancer in a boy: A case report with genetic analysis using next-generation sequencing and literature review

“…By comparison, the adult patients had a larger average tumor size and a higher rate of lymph node metastases. [1] The majority of these pediatric SBC patients are negative for ER, progesterone receptor, and human epidermal growth factor receptor 2, with only 6.6% (1/15) having modest expression of hormone receptors. This is different from other types of male breast cancer since >90% of the latter patients are positive for ER.…”

“…Secretory breast cancer (SBC) is a rare kind of breast cancer, accounting for 0.15% of all invasive breast cancers, with a male-to-female ratio of 1:31 according to National Cancer Database analysis. [1] Because of its rarity, little is known about this disease. Here, we describe a case of SBC in a 5-year-old boy and provide a genetic study of 211 cancer-related genes using capture-based next-generation sequencing.…”

Secretory Breast Carcinoma: Report of Two Cases and Literature Review

“…22 This fusion product has been shown to activate the mitogen-activated protein kinase (MAPK) pathway and promote cell proliferation, contributing to the development of SBC. 13 According to a study, the 5-and 10-year disease-free survival rates for SBC were 94% and 91%, respectively. 23 However, cases of recurrence and metastasis have been reported, and while double primary tumors have been observed, they are exceedingly rare.…”

“…11 SBC is a low-grade tumor that typically has a good prognosis, with a 5-year survival rate of over 95%. [12][13][14] However, there have been a few reported cases of aggressive behavior, including metastases and death. 13 The evolution and overall survival of patients with SBC were reported in a retrospective study conducted on 83 patients.…”

“…[12][13][14] However, there have been a few reported cases of aggressive behavior, including metastases and death. 13 The evolution and overall survival of patients with SBC were reported in a retrospective study conducted on 83 patients. 15 In this study, the majority of patients underwent surgical treatment, with breast-conserving surgery 2 Clinical Medicine Insights: Case Reports being the most common approach.…”