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Carcinoma of the breast in children
M Eskelinen1, J Vainio, L Tuominen
1Department of Surgery, University Central Hospital, Kuopio, Finland.
Insights
Pediatric breast cancer, specifically juvenile secretory carcinoma, is rare. A 9-year-old girl treated with simple mastectomy showed no recurrence after six years, indicating a favorable outcome for this rare childhood cancer.
Area of Science:
- Pediatric Oncology
- Surgical Oncology
Background:
- Breast cancer in children is exceptionally rare, with limited documented cases worldwide.
- Juvenile secretory carcinoma is a distinct histological subtype observed in pediatric breast cancer patients.
Observation:
- A 9-year-old girl presented with a painless right breast mass, raising clinical and mammographic suspicion of malignancy.
- Histological analysis confirmed juvenile secretory carcinoma, characterized by intracellular vacuoles and secretory material.
- Electron microscopy, low mitotic index, diploid DNA content, and low S-phase fraction were noted in the neoplastic cells.
Findings:
- The patient underwent a simple mastectomy with axillary evacuation.
- No lymph node or distant metastases were detected.
- The patient remained recurrence-free for six years post-surgery without adjuvant therapy.
Implications:
- Simple mastectomy with axillary evacuation may be a sufficient treatment for juvenile secretory carcinoma, leading to favorable long-term outcomes.
- This case contributes to the understanding of juvenile secretory carcinoma management in pediatric patients.
- Early diagnosis and surgical intervention appear crucial for successful management of this rare pediatric malignancy.
Abstract:
Carcinoma of the breast in children is an extremely rare disease, only 44 patients have been reported in the world literature. We report on a case of breast cancer in a 9-year-old girl, who was admitted to the hospital because of a four-month history of a painless mass in the right breast. Clinical examination and mammography resulted in a strong suspicion of malignancy. The histology corresponded to juvenile secretory carcinoma, the histological type without the characteristics of prepubertal cancer cases. Electron microscopy demonstrated intracellular large vacuoles and acini filled with secretory material. The mitotic index was low, the highest measured value was 4 mitotic figures per 10 high power fields corresponding to 2.78 mitotic figures per mm2 of epithelium in the microscope field. Flow cytometry showed that the neoplastic cells were diploid and had a low S-phase fraction. A simple mastectomy including axillary evacuation was performed. No lymph node or distant metastases were found. Postoperative radiation treatment or chemotherapy were not administered. Our patient has been in follow-up for six years without recurrence. In this case simple mastectomy with axillary evacuation seems to have given a cancer-free development into adulthood. Earlier reports have also shown a favourable outcome in these tumours.