Definition
Adenoid cystic carcinoma (AdCC) of the breast is a low-grade tumor, composed of epithelial, myoepithelial, and basal cells, showing features similar to the salivary gland counterpart.
Clinical Features
Incidence
AdCC of the breast is a rare tumor, accounting for less than 1% of all breast tumors.
Age
It usually affects elderly female patients, even if rare cases have been reported in children.
Sex
AdCC usually affects female patients, even if rare cases have been reported in males.
Site
AdCC is more frequently located in the retroareolar region, but it can affect all the breast quadrants. It can present as a mass of variable size or as screen detected nodule.
Treatment
Radical surgery is the treatment of choice.
Outcome
AdCC is a low malignant potential tumor therefore prognosis is usually good. Recurrences and disease progression are rare. To better predict prognosis, AdCC should be subdivided in three different categories: (i) AdCC classical variant shows good prognosis,...
References and Further Reading
Brill, L. B., Kanner, W. A., Fehr, A., Andrén, Y., Moskaluk, C. A., Löning, T., Stenman, G., & Frierson, H. F., Jr. (2011). Analysis of MYB expression and MYB-NFIB gene fusions in adenoid cystic carcinoma and other salivary neoplasms. Modern Pathology, 24, 1169–1176.
D’Alfonso, T. M., Mosquera, J. M., MacDonald, T. Y., Padilla, J., Liu, Y. F., Rubin, M. A., & Shin, S. J. (2014). MYB-NFIB gene fusion in adenoid cystic carcinoma of the breast with special focus paid to the solid variant with basaloid features. Human Pathology, 45, 2270–2280.
Foschini, M. P., & Krausz, T. (2010). Salivary gland-type tumors of the breast: A spectrum of benign and malignant tumors including “triple negative carcinomas” of low malignant potential. Seminar in Diagnostic Pathology, 27, 77–90.
Foschini, M. P., Rizzo, A., De Leo, A., Laurino, L., Sironi, M., & Rucco, V. (2016). Solid variant of adenoid cystic carcinoma of the breast: A case series with proposal of a new grading system. International Journal of Surgical Pathology, 24(2), 97–102.
Foschini, M. P., Morandi, L., Asioli, S., Giove, G., Corradini, A. G., & Eusebi, V. (2017). The morphological spectrum of salivary gland type tumours of the breast. Pathology, 49, 215–227.
Fusco, N., Geyer, F. C., De Filippo, M. R., Martelotto, L. G., Ng, C. K., Piscuoglio, S., Guerini-Rocco, E., Schultheis, A. M., Fuhrmann, L., Wang, L., Jungbluth, A. A., Burke, K. A., Lim, R. S., Vincent-Salomon, A., Bamba, M., Moritani, S., Badve, S. S., Ichihara, S., Ellis, I. O., Reis-Filho, J. S., & Weigelt, B. (2016). Genetic events in the progression of adenoid cystic carcinoma of the breast to high-grade triple-negative breast cancer. Modern Pathology, 29, 1292–1305.
Martelotto, L. G., De Filippo, M. R., Ng, C. K., Natrajan, R., Fuhrmann, L., Cyrta, J., Piscuoglio, S., Wen, H. C., Lim, R. S., Shen, R., Schultheis, A. M., Wen, Y. H., Edelweiss, M., Mariani, O., Stenman, G., Chan, T. A., Colombo, P. E., Norton, L., Vincent-Salomon, A., Reis-Filho, J. S., & Weigelt, B. (2015). Genomic landscape of adenoid cystic carcinoma of the breast. Journal of Pathology, 237, 179–189.
Righi, A., Lenzi, M., Morandi, L., Flamminio, F., De Biase, D., Farnedi, A., & Foschini, M. P. (2011). Adenoid cystic carcinoma of the breast associated with invasive duct carcinoma: A case report. International Journal of Surgical Pathology, 19, 230–234.
Shin, S. J., & Rosen, P. P. (2002). Solid variant of mammary adenoid cystic carcinoma with basaloid features: A study of nine cases. American Journal of Surgical Pathology, 26, 413–420.
Vranic, S., Frkovic-Grazio, S., Lamovec, J., Serdarevic, F., Gurjeva, O., Palazzo, J., Bilalovic, N., Lee, L. M., & Gatalica, Z. (2010). Adenoid cystic carcinomas of the breast have low Topo IIα expression but frequently overexpress EGFR protein without EGFR gene amplification. Human Pathology, 41, 1617–1623.
Vranic, S., Gatalica, Z., Deng, H., Frkovic-Grazio, S., Lee, L. M., Gurjeva, O., & Wang, Z. Y. (2011). ER-α36, a novel isoform of ER-α66, is commonly over-expressed in apocrine and adenoid cystic carcinomas of the breast. Journal of Clinical Pathology, 64, 54–57.
Wetterskog, D., Wilkerson, P. M., Rodrigues, D. N., Lambros, M. B., Fritchie, K., Andersson, M. K., Natrajan, R., Gauthier, A., Di Palma, S., Shousha, S., Gatalica, Z., Töpfer, C., Vukovic, V., A’Hern, R., Weigelt, B., Vincent-Salomon, A., Stenman, G., Rubin, B. P., & Reis-Filho, J. S. (2013). Mutation profiling of adenoid cystic carcinomas from multiple anatomical sites identifies mutations in the RAS pathway, but no KIT mutations. Histopathology, 62, 543–550.
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Foschini, M.P., Morandi, L. (2018). Adenoid Cystic Carcinoma. In: van Krieken, J. (eds) Encyclopedia of Pathology. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-28845-1_4697-1
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DOI: https://doi.org/10.1007/978-3-319-28845-1_4697-1
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