A case of cystic hypersecretory carcinoma of the breast with multiple cystic ductal dilatation

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 73; no. 6; pp. 1361 - 1366
• Main Authors: NISHIKAWA, Toru, NAKANO, Hiroshi, FUKUDA, Mamoru, KAWAMOTO, Hisanori, SHINAGAWA, Toshihito, TSUGAWA, Kouichiro
• Format: Journal Article
• Language: Japanese
• Published: Japan Surgical Association 2012
• Subjects: breast cancer; cystic hypersecretory carcinoma
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.73.1361

A 28-year-old woman presented with clear brownish nipple discharge from her right breast. Ultrasound imaging showed a ductal extension from the outer region around the right nipple. In MRI, enhancement imaging demonstrated ductal extension from a CD area. A noninvasive cancer was suggested because of ducts filled with secretion forming cystic extension. A diagnosis could not be made on the basis of the findings from aspiration cytology and core needle biopsy. Ductal carcinoma in situ (DCIS) has been diagnosed on the basis of biopsy findings of surgical specimens. The patient underwent total mastectomy and a tissue expander was placed in the right breast. Histopathological findings revealed a small number of cystic lesions including secretory components inside. The cyst filled with eosinophilic secretion. Invasive components are not observed. On the basis of the pathological test findings, we made a diagnosis of DCIS, cystic hypersecretory carcinoma. Immunohistochemical staining was positive for ER : positive, PgR : positive, and HER2 : 1+. Adjuvant treatment was not performed because she wished to get pregnant. She is being regularly followed up as an outpatient. The patient gave birth to a girl 24 months after surgery, who is alive and well 76 months after the operation.