Abstract
Secretory breast carcinoma constitutes the majority of breast cancers in children and young people less than 20 years of age. Noninvasive examination is particularly necessary for the diagnosis of breast carcinoma in children. Herein, we report a case of secretory breast carcinoma in a 6-year-old girl with psychomotor retardation. She was referred to our outpatient clinic for evaluation of a palpable mass in her left breast. A hard mass, rather than the increase in size typical of premature thelarche, was palpated. An excision biopsy was performed. Pathological findings revealed an invasive secretory breast carcinoma. We performed a retrospective review of the preoperative findings of this case, and compared it to the pathological diagnosis. Elastography, which can be performed without deep sedation or general anesthesia and without causing pain, resulted in a stiffness score of 4; however, the distinction between benign and malignant tumors on elastography, which is important to decide the intra-operative procedures, was not sufficient according to the Japanese breast cancer society clinical guidelines. This is the first report of secretory breast carcinoma in a child with a stiffness score determined by tissue elasticity imaging. A breast mass in a child with a high stiffness score of more than 4 on elastography should be referred for invasive diagnostic procedures, such as fine needle aspiration or excisional biopsy. According to our experience, an accurate preoperative diagnosis could be possible for malignant breast tumors in children. Such parameters as stiffness score on elastography are practical, noninvasive, and objective diagnostic tools for the accurate preoperative diagnosis of breast tumors in children.
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Acknowledgements
We are grateful for the assistance of Mis. Sachiko Chigusa and Mis. Keiko Kutani, laboratory technicians in the division of Laboratory Medicine, Saitama Medical University Hospital, with performing ultrasonography and elastography. In addition, we appreciate proofreading of this article by NAI Inc., Yokohama, Japan.
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TK, MK, AA, TE, KO, TK, HY, HK, TK, KT, TS, CL, KI, TH and AS have no conflicts of interest. HT received a research grant from Chugai Pharmaceutical Co., and Taiho Pharmaceutical Co.. AO has received research grants from AstraZeneca K.K., Eisai Co., Ltd., Ono Pharmaceutical Co., Ltd., Kyowa Hakko Kirin Co., Ltd., Daiichi Sankyo Co., Ltd., Taiho Pharmaceutical Co., Ltd., Sawai Pharmaceutical Co., Ltd., MSD K.K., Chugai Pharmaceutical Co., Ltd., Nippon Kayaku Co., Ltd., Novartis Pharma K.K., Hamamatsu Photonics K.K., Parexel International Inc. and Fuji Pharma Co.
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Gohara, T., Komura, M., Asano, A. et al. A case of secretory breast cancer in a 6 year-old girl: is it possible to make a correct preoperative diagnosis?. Breast Cancer 27, 785–790 (2020). https://doi.org/10.1007/s12282-020-01056-5
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DOI: https://doi.org/10.1007/s12282-020-01056-5