title: Rare breast cancer: 246 invasive secretory carcinomas from the National Cancer Data Base.
abstract: OBJECTIVE
  Invasive secretory breast carcinoma (SBC) is a rare subtype of breast malignancy.
  
  
  METHODS
  Cases of SBC and infiltrating ductal carcinoma (IDC) from the National Cancer Database (1998-2011) were queried.
  
  
  RESULTS
  Patients with SBC (n = 246) and IDC were identified (n = 1,564,068). The group with SBC was younger (age 56.4 ± 16.0 vs. 60.4 ± 13.9 years, P < 0.001), had similar tumor size (19.9 ± 17.8 vs. 21.6 ± 25.5 mm, P = 0.297), more frequently African-Americans (24.1 vs. 14.8 vs. 13.7; P = 0.004), more well-differentiated (32 vs. 18%, P < 0.001) and less likely to be hormone receptor positive (ER: 64 vs. 76%, P = 0.001; PR: 43 vs. 65%, P < 0.001). No differences were found for incidence of node-positivity (32 vs. 34%, P = 0.520) and stage IV presentation (2.4 vs. 3.6%, P = 0.372). Breast conserving surgery (60 vs. 58%, P = 0.405) and hormonal therapy (67 vs. 71%, P = 0.489) rates were similar. Systemic chemotherapy was used less often for SBC (38 vs. 45%, P = 0.035). The overall survival of all patients with SBC was better than all patients with IDC (median not reached vs. 14.8 years, P = 0.025).
  
  
  CONCLUSIONS
  SBC is an uncommon tumor that is often well-differentiated and seen in younger women. Contrary to prior reports, they are frequently hormone receptor-positive. Compared to IDC, overall survival is improved. J. Surg. Oncol. 2016;113:721-725. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Surgery, Abington Hospital-Jefferson Health, Abington, Pennsylvania.
authors.forename: John Doromal
authors.initials: JD
authors.lastname: Jacob
authors.affiliation: Department of Surgery, Abington Hospital-Jefferson Health, Abington, Pennsylvania.
authors.forename: Caitlin
authors.initials: C
authors.lastname: Hodge
authors.affiliation: Surgical Affiliates, Mercy Medical Center, Des Moines, Iowa.
authors.forename: Jan
authors.initials: J
authors.lastname: Franko
authors.affiliation: Department of Surgery, Abington Hospital-Jefferson Health, Abington, Pennsylvania.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Pezzi
authors.affiliation: Surgical Affiliates, Mercy Medical Center, Des Moines, Iowa.
authors.forename: Charles D
authors.initials: CD
authors.lastname: Goldman
authors.affiliation: Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
authors.forename: Vicki Suzanne
authors.initials: VS
authors.lastname: Klimberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D002277:Carcinoma / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009367:Neoplasm Staging; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D018931:Antineoplastic Agents, Hormonal
keywords: National Cancer Data Base; breast cancer; secretory carcinoma