Adenoid cystic carcinoma of the breast: A case report and literature review

Abstract

Adenoid cystic carcinoma (ACC) is a rare malignant tumor of the breast that occurs in <0.1% of all patients diagnosed with breast cancer. The mean patient age at the time of diagnosis is 50–60 years. Typically, the tumor presents as a subareolar mass or as pain in the breast. While the radiological appearances of ACC are generally non-specific, the diagnosis can be made on fine-needle aspiration cytology. In the present study, a 58-year-old female patient was admitted to the Department of Radiation Oncology (Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey) with complaints of pain in the upper outer quadrant of the right breast. An excision biopsy of a lump in the upper outer quadrant revealed ACC, and perineural invasion was present. Subsequently, the patient underwent breast conservation surgery and sentinel lymph node dissection. Pathology from the second surgery depicted ACC in the form of microscopic foci around the initial surgical cavity, with two reactive sentinel lymph nodes and the closest negative margin at 2 mm. The patient was treated with radiotherapy following the surgery. No recurrence and metastasis were found after 20 months of follow-up. In conclusion, mammary ACC is a rare malignant neoplasm of the breast. Although surgery is the main treatment, the optimal adjuvant treatment of ACC of the breast has not yet been determined due to its low incidence.

Adenoid Cystic Carcinoma of The breast: a Clinical Case Report

“…It has favorable prognosis, as lymph node involvement and distant metastasis are uncommon. ACC is characterized by a biphasic pattern and histologically, it consists of proliferating glands and stromal/basement membrane elements (1, 2). While common in salivary gland, this tumor also occurs at the other sites such as in the nasopharynx, trachea, uterine cervix, skin, lungs, and kidneys as well as the breast.…”

“…ACC of the breast occurs between 30 and 90 years of age and more common in women in their fifth and sixth decade of life (2). It typically presents as a slow-growing mass, often in the subareolar area while some ACCs have been associated with breast tenderness and pain.…”

“…Although radiological appearances are often nonspecific, the diagnosis can be made by fine-needle aspiration biopsy (3). ACC is generally negative for the estrogen (ER), progesterone (PR) receptors and HER-2/neu (c-erbB2) (2, 3). In the present case, we report a patient with a diagnosis of ACC of the breast, and aim to present the treatment approach of this rare disease.…”

Current Status and Progress of Breast Adenoid Cystic Carcinoma

“…The incidence of the breast of ACC may be associated with a variety of benign lesions, including micro-gland adenosis, tubular adenoma, adenomyoblastoma and fibroadenoma (Canyilmaz et al, 2014). The breast of ACC rarely incorporates other types of breast cancer, but there are also cases of coexistence of breast of ACC and invasive ductal carcinoma (Righi et al, 2011).…”

“…ACC of the breast occurs between 19 and 97 years of age and more common in women in their fifth and sixth decade of life (Canyilmaz et al, 2014). 338 cases of breast adenoid cystic carcinoma in the past 30 years were analyzed, and the age-adjusted incidence rate was determined to be 0.92 / 100 million person / year.…”