Adenoid cystic carcinoma of female breast-an interesting pathological diagnosis

Abstract

Adenoid cystic carcinoma (ACC) of the breast is a very rare and indolent subtype of malignant breast tumors, accounting for less than 0.1% of all primary breast cancers, occurring in approximately 1 out of 1 million women each year. To date, there have been about 933 cases reported as per English literature. A 50year old female presented with a right breast mass. Sono mammograhy revealed a large, well defined, solid appearing, lobulated mass. On fine needle aspiration, a differential diagnosis of metaplastic carcinoma, phylloide’s tumor, papillary neoplasm and primary chondrosarcoma of the breast was made and biopsy was advised. Partial mastectomy was done and a histopathological diagnosis of Adenoid Cystic Carcinoma of the breast was made. ACC is of special interest because of its favourable prognosis and distinctive histological appearance. Specifically, they are negative for ER, PR, and HER2-neu, yet on microarray genomic analysis, ACC is distinct from triple negative breast cancer. This tumor occurs predominantly in women in their sixth decade and usually presents as a tender breast mass, often in the subareolar area. The optimal treatment of ACC of the breast has not been defined, although the mainstay of treatment is surgery. Both partial mastectomy and modified radical mastectomy have been used, and the role of adjuvant radiation therapy is not clear.