Secretory carcinoma of the breast: the decisions you may face

Cancer page →Second-opinion finder →

2 treatment settings, 1 with more than one named option. Each section lays out the options the standard of care names, what each is for, the trials behind them with their recorded results, the side effects and cautions on record, and questions to ask. Built from the cancer page's standard-of-care rows; nothing here is advice for your case.

Early / localised

Localised disease

One path named

Surgery with clear margins, radiotherapy after breast conservation; chemotherapy is usually not indicated for this indolent type (European working group consensus).

The path, in plain words

Sentinel lymph node biopsyStandard of care

Removing just the first lymph node a tumour drains to, instead of all of them, to check for spread.

Avoids lymphoedema from full dissection

Also referenced:Lumpectomy (breast-conserving surgery)Mastectomy

The evidence behind it

No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.

The main trade-offs on record

Sentinel lymph node biopsy

False negatives in ~5-10%

Questions to ask about this decision

Is Sentinel lymph node biopsy the only reasonable path for me, or is there a trial, a different sequence or a wait-and-see option?
Why: A single standard does not mean a single choice; timing and trials are decisions too.
What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?
Why: The aim shapes how much side effect and disruption is worth accepting.
What happens if I delay, or decline this step for now? Is the decision reversible?
Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
For my situation (localised disease), which of the standard options do you recommend and why?
Why: Guideline options include: Surgery with clear margins, radiotherapy after breast conservation; chemotherapy is usually not indicated for this indolent type (European working group consensus).

Add these to your appointment list, or take the full question set for this cancer.

Advanced, first line

Metastatic disease (rare)

2 optionsCompare side by side →

NTRK inhibitors (larotrectinib, entrectinib) under their tumour-agnostic approvals for NTRK fusion-positive solid tumours.

The options, in plain words

LarotrectinibApprovedSmall-molecule pan-TRK inhibitor (first generation)

The first drug approved for a gene fusion regardless of where the cancer started; it works in about 75% of NTRK-fusion cancers, from infant fibrosarcoma to salivary and thyroid cancers.

EntrectinibApprovedSmall-molecule TRK/ROS1/ALK TKI (CNS-penetrant)

Entrectinib (Rozlytrek) is a pill for NTRK-fusion cancers and ROS1 lung cancer that reaches brain metastases.

Also referenced:Tumour-agnostic (tissue-agnostic) approval

The evidence behind it

No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.

The main trade-offs on record

Entrectinib all recorded rates →

Avoid grapefruit.
Known QT prolongation. Avoid other QT-prolonging drugs where possible; check ECG and correct potassium and magnesium before and during treatment.

Questions to ask about this decision

Between Larotrectinib and Entrectinib, which do you recommend for me, and what about my case would make you choose differently?
Why: Guidelines list several reasonable options; the choice turns on details of your tumour, your health and your priorities.
What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?
Why: The aim shapes how much side effect and disruption is worth accepting.
What happens if I delay, or decline this step for now? Is the decision reversible?
Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
For my situation (metastatic disease (rare)), which of the standard options do you recommend and why?
Why: Guideline options include: NTRK inhibitors (larotrectinib, entrectinib) under their tumour-agnostic approvals for NTRK fusion-positive solid tumours.
Am I a candidate for Larotrectinib, Entrectinib, and what side effects should I expect?
Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Add these to your appointment list, or take the full question set for this cancer.

How to read this page. Options and results come from OnCo records with their sources; the settings are the standard-of-care rows on the cancer page, and the lines of therapy are on the sequencing grid. Where a setting names one path, the choice is usually about timing, trials and where to be treated: see expert centres. OnCo is orientation, not medical advice.

Living with cancer·Standard of care

Secretory carcinoma of the breast: the decisions you may face

Cancer page →Second-opinion finder →

Early / localised

Localised disease

One path named

Surgery with clear margins, radiotherapy after breast conservation; chemotherapy is usually not indicated for this indolent type (European working group consensus).

The path, in plain words

Sentinel lymph node biopsyStandard of care

Removing just the first lymph node a tumour drains to, instead of all of them, to check for spread.

Avoids lymphoedema from full dissection

Also referenced:Lumpectomy (breast-conserving surgery)Mastectomy

The evidence behind it

No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.

The main trade-offs on record

Sentinel lymph node biopsy

False negatives in ~5-10%

Questions to ask about this decision

Is Sentinel lymph node biopsy the only reasonable path for me, or is there a trial, a different sequence or a wait-and-see option?
Why: A single standard does not mean a single choice; timing and trials are decisions too.
What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?
Why: The aim shapes how much side effect and disruption is worth accepting.
What happens if I delay, or decline this step for now? Is the decision reversible?
Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
For my situation (localised disease), which of the standard options do you recommend and why?
Why: Guideline options include: Surgery with clear margins, radiotherapy after breast conservation; chemotherapy is usually not indicated for this indolent type (European working group consensus).

Add these to your appointment list, or take the full question set for this cancer.

Advanced, first line

Metastatic disease (rare)

2 optionsCompare side by side →

NTRK inhibitors (larotrectinib, entrectinib) under their tumour-agnostic approvals for NTRK fusion-positive solid tumours.

The options, in plain words

LarotrectinibApprovedSmall-molecule pan-TRK inhibitor (first generation)

The first drug approved for a gene fusion regardless of where the cancer started; it works in about 75% of NTRK-fusion cancers, from infant fibrosarcoma to salivary and thyroid cancers.

EntrectinibApprovedSmall-molecule TRK/ROS1/ALK TKI (CNS-penetrant)

Entrectinib (Rozlytrek) is a pill for NTRK-fusion cancers and ROS1 lung cancer that reaches brain metastases.

Also referenced:Tumour-agnostic (tissue-agnostic) approval

The evidence behind it

No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.

The main trade-offs on record

Entrectinib all recorded rates →

Avoid grapefruit.
Known QT prolongation. Avoid other QT-prolonging drugs where possible; check ECG and correct potassium and magnesium before and during treatment.

Questions to ask about this decision

Between Larotrectinib and Entrectinib, which do you recommend for me, and what about my case would make you choose differently?
Why: Guidelines list several reasonable options; the choice turns on details of your tumour, your health and your priorities.
What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?
Why: The aim shapes how much side effect and disruption is worth accepting.
What happens if I delay, or decline this step for now? Is the decision reversible?
Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
For my situation (metastatic disease (rare)), which of the standard options do you recommend and why?
Why: Guideline options include: NTRK inhibitors (larotrectinib, entrectinib) under their tumour-agnostic approvals for NTRK fusion-positive solid tumours.
Am I a candidate for Larotrectinib, Entrectinib, and what side effects should I expect?
Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Add these to your appointment list, or take the full question set for this cancer.