title: Secretory breast carcinoma with metastatic sentinel lymph node.
abstract: BACKGROUND
  Secretory mammary carcinoma is a rare breast neoplasia originally described in children but sometimes also found in adults. It presents a more favourable outcome than more common histological types of breast carcinoma; published literature in fact reports only a few cases with axillary lymph node metastases and only four cases with distant metastases.
  
  
  METHODS
  In this paper we report a rare case of secretory breast carcinoma with axillary lymph node metastases in a 33-year-old woman. To our knowledge, this is the first case of secretory carcinoma involving biopsy of the sentinel lymph node and investigation of the e-cadherin expression. We found positivity for e-cadherin, which would support the hypothesis that this type of tumour is a variant of the infiltrating ductal carcinoma.
  
  
  CONCLUSIONS
  After a careful analysis of reported data, we have come to the conclusion that the treatment of choice for patients with secretory breast carcinoma should be conservative surgery with sentinel lymph node biopsy, followed by accurate follow-up. We are of the opinion that while post-operative radiotherapy is indicated in adult patients who have undergone quadrantectomy, it should not be used in children. Although several cases of secretory carcinoma have been treated with adjuvant chemotherapy, there are still no reliable data regarding the real value of such a choice.
authors.affiliation: Department of Oncology, Division of General and Oncological Surgery, University of Palermo, Palermo, Italy. salvatorevieni@tiscali.it
authors.forename: Salvatore
authors.initials: S
authors.lastname: Vieni
authors.forename: Daniela
authors.initials: D
authors.lastname: Cabibi
authors.forename: Calogero
authors.initials: C
authors.lastname: Cipolla
authors.forename: Salvatore
authors.initials: S
authors.lastname: Fricano
authors.forename: Giuseppa
authors.initials: G
authors.lastname: Graceffa
authors.forename: Mario Adelfio
authors.initials: MA
authors.lastname: Latteri