Adenoid Cystic Carcinoma Breast: a Rare Entity

Santosh, Tummidi; Prasad, Shubhra; Joshi, Deepti; Tandon, Ashwani; Mohan, A.; Saxena, Pradeep; Kapoor, Neelkamal

doi:10.1007/s13193-020-01106-6

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…Cellular spindle cell stromal fragments and increased background spindle cells along with large, opened out epithelial sheets favor phyllodes, evidence that is reinforced by our regression model. The lack of a cohort assessed by core needle biopsies and its comparison with FNA remains a limitation of our study, especially with the former being increasingly recommended [35,36]. However, the goal of our study was to unravel FNA findings which can help distinguish PT from FA in resource-limited settings where core needle biopsies cannot be afforded by patients due to financial constraints.…”

Section: Discussionmentioning

confidence: 99%

Fibroadenoma versus phyllodes tumor: a vexing problem revisited!

et al. 2020

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Background: Fibroepithelial lesions of the breast include fibroadenoma (FA) and phyllodes tumor (PT). Fibroadenomas are benign while phyllodes tumor range from benign, indolent neoplasms to malignant tumors capable of distant metastasis. Our study was to determine the select cytologic features that can accurately distinguish FA from PT. Methods: A retrospective review was performed of patients who had histopathology follow up of FA or PT and on whom a pre-operative fine needle aspiration was performed. Cytologic criteria i.e. epithelial component, stromal component and background cellularity were assessed. Results: 46 FA and 24 PT were specimens were reviewed. Median age and tumor size for FA and PT were 23.0 and 39.0 years, and 2.0 and 5.0 cm, respectively. Univariate analysis and regression models based on generalized estimating equations revealed that large opened out, folded epithelial sheets, frayed and irregular stromal fragment contours, spindle stromal cell nuclei, spindle cell nuclei in the background and background cell atypia are significant cytological predictors of PT. The GEE regression model achieved 78.9% diagnostic accuracy (p < 0.001) in identifying PT based on cytological features. Median epithelial: stromal ratio was 3.4 and 2.6 for FA and PT, respectively. Conclusion: Presence of large, opened out, folded epithelial sheets, frayed and irregular stromal contours with spindle nuclei, background spindle cells and atypia can help distinguish PT from FA.

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Section: Discussionmentioning

confidence: 99%

Fibroadenoma versus phyllodes tumor: a vexing problem revisited!

et al. 2020

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“…The mainstay of treatment of ACCB has not yet been established due to its rare incidence and indolent behavior, which can be confirmed in the literature, as there are mainly case reports, [7][8][9][10][11] or small series. 2,3,12,13 Regarding histological classification, several scores can be applied.…”

Section: Introductionmentioning

confidence: 99%

Adenoid Cystic Carcinoma of the Breast: An Oncological Center's Experience

et al. 2022

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Background: Adenoid cystic carcinoma of the breast (ACCB) is a rare breast malignancy. Despite often being a triple negative tumor, it has a favorable prognosis, with low rates of recurrence and progression. The ideal treatment of ACCB is debatable; thus, the aim of this study was to characterize a population diagnosed with ACCB and to evaluate the treatment outcomes.Methods: We performed a single-center retrospective analysis of patients with a histological diagnosis of ACCB treated at our dedicated Oncological Center between 1987 and 2020. The patients were identified in collaboration with the Anatomical Pathology Department, which also reviewed the surgical pathology reports.Results: Thirteen women with a median age of 68 years old were diagnosed with ACCB. The most frequent clinical diagnosis was a breast nodule (n=5); the preoperative image was suggestive of malignancy in nine patients, with seven being diagnosed with a ACCB in the preoperative biopsy. Regarding treatment, nine patients underwent conservative surgery, but three required re-excision. Sentinel lymph node biopsy (SLNB) was performed in seven patients, none revealing metastases; one patient had stage III ACCB and was initially treated with a modified radical mastectomy (MRM); the remaining were stage I (n=7) and II (n=5). Adjuvant radiotherapy was performed in eight patients, and two were initially proposed for chemotherapy but were considered unfit. With a median follow-up of 123 months (16-407), one case of local recurrence and two cases of distant metastasis were identified, one of whom died of disease. Conclusion: ACCB is a rare tumor with a good prognosis; however, as demonstrated, it can present an aggressive behavior. Conservative surgery and adjuvant radiotherapy are the indicated treatment and SLNB may be omitted in grade 1 tumors.

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Adenoid Cystic Carcinoma Breast: a Rare Entity

Cited by 2 publications

References 17 publications

Fibroadenoma versus phyllodes tumor: a vexing problem revisited!

Fibroadenoma versus phyllodes tumor: a vexing problem revisited!

Adenoid Cystic Carcinoma of the Breast: An Oncological Center's Experience

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