Breast malignant, males, children
Carcinoma subtypes
Secretory carcinoma

Author: Monika Roychowdhury, M.D. (see Authors page)

Revised: 2 January 2017, last major update August 2012

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed search: Secretory carcinoma [title] breast

Cite this page: Secretory carcinoma. PathologyOutlines.com website. http://pathologyoutlines.com/topic/breastmalignantjuvenile.html. Accessed March 29th, 2017.
Definition / General
  • Tumor cells with granular eosinophilic cytoplasm and prominent intracellular and extracellular milk-like secretion
  • First described in 1966 as juvenile carcinoma by McDivitt and Stewart (JAMA 1966;195:388)
  • A type of basal-like carcinoma (triple negative with expression of basal cytokeratins, Mod Pathol 2009;22:291)
Terminology
  • Also called juvenile carcinoma
Epidemiology
  • Rare, usually children (most common form of breast carcinoma in children), but can occur in adults
  • Rare in males
Case Reports
Clinical Images

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17 year old boy with breast mass and skin involvement



Flickr images:

7 year old Ethiopian girl with breast mass present for 2 years

Gross Description
  • Small, well circumscribed and often near areola
Micro Description
  • Sheet-like growth, usually circumscribed, pushing margins, occasional foci of infiltration (Stanford University - Secretory Carcinoma of the Breast)
  • Tubuloalveolar and focally papillary formations composed of relatively bland cells with uniform, low grade nuclei
  • Abundant pale to eosinophilic, often vacuolated cytoplasm, but little pleomorphism
  • Prominent nucleoli
  • PAS+ diastase resistant eosinophilic secretions
  • Also prominent hyalinization centrally, in situ component
  • No atypia, no / rare mitotic figures
  • May be difficult to differentiate in situ from invasive disease
Micro Images

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Courtesy of Dr. Mark R. Wick

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Case of the Week #8



AFIP images:

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Intraductal component with microcystic features

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Microcystic pattern below, solid apocrine pattern above

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Secretion tends to shrink
toward center of lumen,
may have a scalloped bor-
der in larger microcysts



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H&E, PAS

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Intracytoplasmic lumen, H&E

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Arising within radial scar


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Various images

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Well differentiated but invasive glands

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PAS, S100, E-cadherin


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S100+

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PAS+ diastase resistant secretions

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S100, EMA, pan cytokeratin, ER

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Various images



Cytology Description
Positive Stains
Negative Stains
  • Usually ER, PR and HER2 (triple negative)
Electron Microscopy Description
  • Numerous membrane bound, intracytoplasmic secretory vacuoles
Electron Microscopy Images

Images hosted on PathOut server:

Large irregular cytoplasmic vacuoles lined by villi (AFIP)

Molecular / Cytogenetics Description
Molecular / Cytogenetics Images

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FISH shows t(12;15)

t(12;15) in 6 year old girl

Differential Diagnosis