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

Ana Margarida Correia (1), Rafael Fernandes (2), Teresa Dias (3), Madalena Souto Moura (4), Rita Canotilho (5), Catarina Baía (6), Paula Pinto (7), Joaquim Abreu de Sousa (8)
(1) Surgical Oncology Department, Instituto Português de Oncologia do Porto Francisco Gentil (IPO-Porto), Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal, Portugal,
(2) General Surgery Department, Hospital de Santa Cruz – Centro Hospitalar de Lisboa Ocidental, Av. Prof. Dr. Reinaldo dos Santos, 2790-134 Carnaxide, Lisboa, Portugal, Portugal,
(3) Surgical Oncology Department, Instituto Português de Oncologia do Porto Francisco Gentil (IPO-Porto), Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal, Portugal,
(4) Anatomical Pathology Department, Instituto Português de Oncologia do Porto Francisco Gentil (IPO-Porto), Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal, Portugal,
(5) Surgical Oncology Department, Instituto Português de Oncologia do Porto Francisco Gentil (IPO-Porto), Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal, Portugal,
(6) Surgical Oncology Department, Instituto Português de Oncologia do Porto Francisco Gentil (IPO-Porto), Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal, Portugal,
(7) Surgical Oncology Department, Instituto Português de Oncologia do Porto Francisco Gentil (IPO-Porto), Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal, Portugal,
(8) Surgical Oncology Department, Instituto Português de Oncologia do Porto Francisco Gentil (IPO-Porto), Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal, Portugal

Abstract

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.

Full text article

Generated from XML file

References

Lannaz S OI, Bensouda Y, Mrabti H, Errihani H. A Rare Case of Adenoid Cystic Carcinoma of the Breast: Discussion and Review of the Literature Case Rep Clin Med. 2014;3(7):433-6. doi: 10.4236/crcm.2014.37096.

Treitl D RP, Rizer M, Hussein SE, Paramo JC, Mesko TW. Adenoid cystic carcinoma of the breast, 20 years of experience in a single center with review of literature. Breast Cancer. 2018 Jan;25(1):28-33. doi: 10.1007/s12282-017-0780-1.

Zhang W FY, Zhang Z, Wang J. Management of Adenoid Cystic Carcinoma of the Breast: A Single-Institution Study. Front Oncol. 2021;11: 621012. doi: 10.3389/fonc.2021.621012.

Wetterskog D L-GM, Lambros MB, A'Hern R, Geyer FC, Milanezi F, et al. Adenoid cystic carcinomas constitute a genomically distinct subgroup of triple-negative and basal-like breast cancers. J Pathol. 2012 Jan;226(1):84-96. doi: 10.1002/path.2974.

Naidoo K PS. Immunohistochemistry for Triple-Negative Breast Cancer. Methods Mol Biol. 2016;1406:39-51. doi: 10.1007/978-1-4939-3444-7_3.

Thompson K GJ, Saltzstein SL, Sadler GR, Blair SL. Adenoid cystic breast carcinoma: is axillary staging necessary in all cases? Results from the California Cancer Registry. Breast J. 2011 Sep-Oct;17(5):485-9. doi: 10.1111/j.1524-4741.2011.01117.x.

Veeratterapillay R VS, Ward E, Khout H, Fasih T. Adenoid cystic carcinoma of the breast: case report and review of literature. Ann R Coll Surg Engl. 2012 May;94(4):e137-8. doi: 10.1308/003588412X13171221499829.

Nozoe T NE, Ohga T, Ezaki T, Sueishi K. A case of adenoid cystic carcinoma of the breast. J Med Invest. 2018;65(3.4):289-91. doi: 10.2152/jmi.65.289.

Cambruzzi E PK, Zettler CG, Zettler EW. Adenoid cystic carcinoma of the breast: a case report of a rare neoplasm. Rev AMRIGS. 2012 Apr-Jun;56 (2):161-163. Available at: https://pesquisa.bvsalud.org/portal/resource/pt/biblio-997892

Tummidi S PS, Joshi D, Tandon A, Mohan A, Saxena P, et al. Adenoid Cystic Carcinoma Breast: a Rare Entity. Indian J Surg Oncol. 2020 Sep;11(Suppl 2):226-231. doi: 10.1007/s13193-020-01106-6.

Gillie B KM, Asarian A, Xiao P. Adenoid cystic carcinoma of the breast with distant metastasis to the liver and spleen: a case report. J Surg Case Rep. 2020 Nov;2020(11): rjaa483. doi: 10.1093/jscr/rjaa483.

Kander E RS, Dhamne S, Solari M, Jain S. Adenoid Cystic Carcinoma of the Breast from a Single-Center Cohort. Cancer Treat Com. 2015;4:182–7. doi: 10.1016/j.ctrc.2015.10.002.

Sołek JM BM, Kalwas M, Jesionek-Kupnicka D, Romańska HM. Adenoid cystic carcinoma of the breast – an uncommon malignancy with unpredictable clinical behaviour. A case series of three patients. Contemp Oncol (Pozn). 2020;24(4): 263–265. doi: 10.5114%2Fwo.2020.99025.

Ro JY SE, Gallager HS. Adenoid cystic carcinoma of the breast. Hum Pathol. 1987 Dec;18(12):1276-81. doi: 10.1016/S0046-8177(87)80413-6.

Board WCoTE. Breast Tumours. WHO Classification of Tumours. 2019;5th ed., vol. 2, Lyon, France: International Agency for Research on Cancer. doi: https://dipot.ulb.ac.be/dspace/bitstream/2013/303138/3/Tan_et_al-2020-Histopathology.pdf

Coates JM MS, Bold RJ, Chen SL. Adjuvant radiation therapy is associated with improved survival for adenoid cystic carcinoma of the breast. J Surg Oncol. 2010 Sep 15;102(4):342-7. doi: 10.1002/jso.21638.

Khanfir K KA, Villette S, Belkacémi Y, Vautravers C, Nguyen T, et al. Management of adenoid cystic carcinoma of the breast: a Rare Cancer Network study. Int J Radiat Oncol Biol Phys. 2012 Apr 1;82(5):2118-24. doi: 10.1016/j.ijrobp.2010.12.008.

Senkus E KS, Ohno S, Penault-Llorca S, Poortmans P, Rutgers E, et al. Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2015 Sep;26 Suppl 5:v8-30. doi: 10.1093/annonc/mdv298.

Kulkarni N PC, Greif JM, Klimberg VS, Bailey L, Korourian S, et al. Rare breast cancer: 933 adenoid cystic carcinomas from the National Cancer Data Base. Ann Surg Oncol. 2013 Jul; 20(7):2236-41. doi: 10.1245/s10434-013-2911-z.

Canyilmaz E UG, Memış Y, Bahat Z, Yildiz K, Yoney A. Adenoid cystic carcinoma of the breast: A case report and literature review. Oncol Lett. 2014 May;7(5):1599-601. doi: 10.3892/ol.2014.1945.

Ghabach B AW, Curtis RE, Huycke MM, Lavigne JA, Dores GM. Adenoid cystic carcinoma of the breast in the United States (1977 to 2006): a population-based cohort study. Breast Cancer Res. 2010;12(4):R54. doi: 10.1186/bcr2613.

Mhamdi HA KH, Jungels C, Aftimos P, Belbaraka R, Piccart-Gebhart M. Adenoid cystic carcinoma of the breast - an aggressive presentation with pulmonary, kidney, and brain metastases: a case report. J Med Case Rep. 2017 Oct 29;11(1):303. doi: 10.1186/s13256-017-1459-0.

Kim M LD, Im J, Suh KJ, Keam B, Moon HG, et al. Adenoid cystic carcinoma of the breast: a case series of six patients and literature review. Cancer Res Treat. 2014 Jan;46(1):93-7. doi: 10.4143%2Fcrt.2014.46.1.93.

Welsh JL KM, Hoskin TL, Glazebrook KN, Boughey JC, Shah SS, et al. Is axillary surgery beneficial for patients with adenoid cystic carcinoma of the breast? J Surg Oncol. 2017 Nov;116(6):690-695. doi: 10.1002/jso.24702.

Cadoo KA MO, O'Shea AM, Power CP, Hennessy BT. Management of unusual histological types of breast cancer. Oncologist. 2012;17(9):1135-45. doi: 10.1634%2Ftheoncologist.2012-0134.

Mastropasqua MG ME, Pruneri G, Orvieto E, Mazzarol G, Vento AR, et al. Immunoreactivity for c-kit and p63 as an adjunct in the diagnosis of adenoid cystic carcinoma of the breast. Mod Pathol. 2005 Oct;18(10):1277-82. doi: 10.1038/modpathol.3800423.

Authors

Ana Margarida Correia
ambbpc@gmail.com (Primary Contact)
Rafael Fernandes
Teresa Dias
Madalena Souto Moura
Rita Canotilho
Catarina Baía
Paula Pinto
Joaquim Abreu de Sousa
1.
Correia AM, Fernandes R, Dias T, Souto Moura M, Canotilho R, Baía C, Pinto P, Abreu de Sousa J. Adenoid Cystic Carcinoma of the Breast: An Oncological Center’s Experience. Arch Breast Cancer [Internet]. 2022 Jan. 23 [cited 2024 Apr. 23];9(1):76-82. Available from: https://www.archbreastcancer.com/index.php/abc/article/view/456

Article Details