CASE REPORT Secretory breast carcinoma in a 6-year-old girl: mastectomy with sentinel lymph node dissection Tutku Soyer 1 • I ˙ nci Yaman Bajin 2 • Diclehan Orhan 3 • Bilgehan Yalc ¸in 2 • Pinar O ¨ zgen Kiratli 4 • Berna Og ˘uz 5 • I ˙ brahim Karnak 1 Accepted: 12 May 2015 / Published online: 21 May 2015 Ó Springer-Verlag Berlin Heidelberg 2015 Abstract Secretory breast carcinoma (SBC) is a rare type of breast neoplasia that was originally described in chil- dren. SBC is an indolent breast tumor with good clinical outcome and rare systemic involvement. Since, majority of studies concerning pediatric SBC have been case reports, it has been difficult to clearly elucidate the characteristics and optimal treatment strategies for SBC in children. Although treatment recommendations vary, surgical excision is the primary mode of treatment. Also, necessity of axillary and/ or sentinel lymph node dissection is another matter of discussion in children. We report a 6-year-old girl who was diagnosed as SBC was reported to discuss the use of mastectomy with sentinel lymph node dissection in the treatment of this rare tumor in children. Keywords Secretory breast carcinoma Á Sentinel lymph node Á Children Introduction Secretory breast carcinoma (SBC) is one of the rarest types of breast cancer, accounting less than 1 % of all breast cancers [1]. It was originally described in children and formerly called as ‘juvenile breast carcinoma’ [2]. Longo et al. reviewed 22 cases before 1999 and twelve new cases were included up to now [3]. Since the tumor consisted of large amounts of in- tracellular and extracellular secretory material, the tumor is called as ‘secretory breast carcinoma’ [4]. SBC occurs in both sexes with male to female ratio of 1:6 [5]. Secretory carcinoma may occur in any part of breast as a painless, well-circumscribed, mobile mass [1]. The tumor has an indolent clinical course with good prognosis and rare systemic involvement. Therefore, most of the authors suggest preservation of breast bud in prepubertal children. However, the possibility of relapse after simple excision of the local disease suggests mastectomy as the most appropriate treat- ment of choice in children. Although, lymph node metastasis can be seen in 30 % of cases, complete axillary lymph node dissection is still subject of discussion [4]. In the last few years, to avoid complete dissection of axillary lymph nodes, sentinel lymph node mapping has been recommended [6]. We report a 6-year-old girl with SBC who underwent mastectomy and sentinel lymph node mapping with both intravital stain and radiotracer with a portable radioisotope detector for intraoperative identification and subsequent removal of lymph nodes. Case report A 6-year-old girl was admitted to another center with a well-circumscribed 14 9 10 mm-mass localized at sub- aerolar of right breast. She underwent total excision of & Tutku Soyer soyer.tutku@gmail.com 1 Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey 2 Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey 3 Department of Pediatric Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey 4 Department of Nuclear Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey 5 Department of Pediatric Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey 123 Pediatr Surg Int (2015) 31:677–681 DOI 10.1007/s00383-015-3721-0