Abstract

Acinic cell carcinoma (ACC) of the breast is a rare histological form of triple-negative breast cancer (TNBC). Despite its unique histology, targeted sequencing analysis has failed to identify recurrent genetic alterations other than those found in common forms of TNBC. Here we subjectedthree breast ACCs to whole-exome and RNA sequencing to determine whether they wouldharbour a pathognomonic genetic alteration. DNA and RNA samples from three breast ACCs were subjected to whole-exome sequencingand RNA-sequencing, respectively. Somatic mutations, copy number alterations, mutational signatures and fusion genes were determined with state-of-the-art bioinformatics methods. Our analyses revealed TP53 hotspot mutations associated with loss of heterozygosity of the wild-type allele in two cases. Mutations affecting homologous recombination DNA repair-related genes were found in two cases, and an MLH1 pathogenic germline variant was found in one case. In addition, copy number analysis revealed the presence of a somatic BRCA1 homozygous deletion and focal amplification of 12q14.3-12q21.1, encompassing MDM2, HMGA2, FRS2, and PTPRB. No oncogenic in-frame fusion transcript was identified in the three breast ACCs analysed. No pathognomonic genetic alterations were detected in the breast ACCs analysed. These tumours have somatic genetic alterations similar to those of common forms of TNBC, and may show homologous recombination deficiency or microsatellite instability. These findings provide further insights into why breast ACCs, which are usually clinically indolent, may evolve into or in parallel with high-grade TNBC.

Highlights

  • Acinic cell carcinoma of the breast (ACC) is an exceedingly rare special histologic type of breast cancer.[1]

  • All ACCs were of histologic grade 1, not associated with high-grade triple-negative breast cancer (TNBC) or any other lesions, including microglandular adenosis and lacked estrogen receptor (ER) and HER2 expression (Supplementary Table 1)

  • Our analysis revealed clonal TP53 hotspot mutations associated with loss of heterozygosity (LOH) of the wild-type allele in two ACCs

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Summary

Introduction

Acinic cell carcinoma of the breast (ACC) is an exceedingly rare special histologic type of breast cancer.[1]. Previous studies from our group[3, 5] and others[4, 6] revealed that breast ACCs, microglandular adenosis (MGA) and atypical MGA, which show marked phenotypic overlap, display genetic alterations characteristic of common forms of TNBC, including complex patterns of copy number alterations (CNAs) and highly recurrent TP53 mutations. These observations suggest that these entities may represent a low-grade triple-negative breast neoplasia family with no or minimal metastatic potential even when not associated with high-grade TNBC.[5, 7]

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