Update on adenoid cystic carcinoma breast: A rare, special subtype of breast cancer: Review

• Author Details:   
• Sunil Vitthalrao Jagtap ^*
• Shubham S Jagtap
• Anshuli M Vispute
• Abhilasha S Jadhav
• Shivani V Khillare
• Ipsita Singh

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Introduction: Adenoid cystic carcinoma (ACC) of the breast is a rare special subtype of breast cancer. It is characterized by its slow-growing tumor and low rate of recurrence. A 49 -year-old female presented with history of a gradually increasing, firm palpable, painless mass in right breast of six months duration. On physical examination, the single, mobile, firm mass measuring 3.0 x2.5x 1.5 cm was noted in right upper outer quadrant of breast. FNAC was positive for low grade carcinoma cells. The mammogram was graded as per (Breast Imaging Reporting and Data System category (BI-RADS): 4, suspicious for malignantneoplasm. Patient underwent surgical treatment of wide excision of right breast lump with clear margins and right axillary nodal resections. On gross examination showed well circumscribed, firm, solid and microcystic tumor measuring 2.0 x1.2x 1.0 cm. Cut section showed single pink-grey, firm to soft tumor with microcysts formation. Microscopic examination reported as Adenoid cystic carcinoma, histologic classic variant, sub-type-tubular, cribriform, with solid areas (20%) of right breast. Immunohistochemical staining were negative for Estrogen receptor (ER), Progesterone receptor (PR), and Human Epidermal Growth Factor Receptor 2 new (HER-2) and positive for CK5, CK7, P63, and PAS. Tumor showed Ki-67 proliferation index of 10%. Patient underwent surgical treatment and advised regular follow-up, which showed a favourable prognosis with no evidence of recurrence or any metastasis.

Conclusion: Adenoid cystic carcinoma of the breast is a rare special subtype of breast cancer. ACC is characterized by slow tumor progression, low malignant potential, rare axillary lymph node metastasis, usually triple negative, low expression of Ki-67, and overall favorable prognosis. Herewith emphasis on the recent update and review on ACC breast.