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Secretory Carcinoma of the Breast

Sonographic Features

Department of Radiology and Center for Imaging Science (S.H.M., E.Y.K., B.-K.H., J.H.S., S.J.K.) and Department of Pathology (E.Y.C.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Radiology, Catholic University of Daegu, College of Medicine, Daegu, Korea (S.H.M); and Department of Radiology, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea (S.J.K.).

Address correspondence to Eun Young Ko, MD, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Korea. E-mail: claudel{at}smc.samsung.co.kr

Objective. The purpose of this series was to evaluate the sonographic features of secretory carcinoma of the breast. Methods. Between 1994 and 2006, 9 patients had histologically confirmed secretory carcinoma of the breast in our institution, and 6 of them underwent breast sonography. We retrospectively evaluated the sonographic findings of the patients in correlation with other available images and reviewed the clinical records. Results. Clinical manifestations were a palpable mass (n = 3), a bloody nipple discharge (n = 1), and screening-detected abnormalities (n = 2). Breast sonograms showed masses with a round or oval (n = 5) or tubular (n = 1) shape, with relatively well-circumscribed (n = 2) or partially microlobulated (n = 4) margins, and with a hypoechoic (n = 4) or an isoechoic (n = 2) internal echo texture. Most lesions were single nodules (n = 3) or groups of nodules (n = 2) measuring 1 cm or smaller, except 1 mass measuring 3.5 cm with axillary lymph node metastasis. Two cases had associated ductectasia. Sonographic assessments were classified as Breast Imaging Reporting and Data System category 3 in 2 cases, category 4A in 3 cases, and category 4B in 1 case. Conclusions. Secretory carcinoma of the breast is frequently shown as a small benign-looking nodule or group of nodules or sometimes as an intraductal lesion with a low clinical stage on sonography. Although secretory carcinoma is a rare breast malignancy, awareness of its sonographic features will be helpful for the differential diagnosis.

Key Words: breast cancer • secretory carcinoma • sonography

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