Cancer Genetics and Epigenetics 2017, Vol.5, No.2, 6-10
6
Research Report Open Access
Current Status and Progress of Breast Adenoid Cystic Carcinoma
Zhai Z.W.
1
, You S.R.
1
, Zhao B.Z.
1
, Zhang J.Y.
1
, Zhang D.W.
1, 2
1 The Second Hospital of Harbin Medical University, Harbin, 150081, China
2 Heilongjiang Academy of Medical Sciences, Harbin, 150081, China
Corresponding author email
Cancer Genetics and Epigenetics, 2017, Vol.5, No.2 doi
Received: 31 Oct., 2017
Accepted: 06 Nov., 2017
Published: 17 Nov., 2017
Copyright © 2017
Zhai et al., This is an open access article published under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Preferred citation for this article:
Zhai Z.W., You S.R., Zhao B.Z., Zhang J.Y., and Zhang D.W., 2017, Current status and progress of breast adenoid cystic carcinoma, Cancer Genetics and
Epigenetics, 5(2): 6-10 (doi
Abstract
Adenoid cystic carcinoma (ACC) of the breast is a rare subtype of breast cancer. Despite its triple-negative status, this
tumor has a very good prognosis. Breast-conserving treatment including postoperative radiotherapy seems to be equivalent to
mastectomy alone with respect to survival. Routine axillary lymph node staging is not recommended since lymph node metastases
are extremely rare. The value of adjuvant systemic therapies is not established. Late relapses can occur, so long-term follow-up is
mandatory for these patients.
Keywords
Adenoid cystic carcinoma; Breast cancer; Radiotherapy; Surgery; Therapy
Background
Adenoid cystic carcinoma (ACC) is an epithelial malignancy occurring in the salivary gland, submandibular gland,
trachea, lungs, breast, skin and other parts of the body (Jang et al., 2014). The histological type of the typical
mammary gland ACC is similar to that of the well-known salivary gland-derived tumor, but the prognosis for
ACC of the breast is better when compared to the salivary gland. ACC of the breast belongs to the basal cell
subgroup of breast cancer, and its immunohistochemical features are consistent with triple-negative breast cancer
with basal-like features, but it usually exhibits low aggressive and inert clinical behavior. These unique
clinicopathological features make it different from other triple-negative breast cancer. This review summarizes the
important advances in epidemiology, clinical features, histomorphology, immunohistochemical features, treatment
and prognosis of breast adenoid cystic carcinoma.
1 Epidemiology
ACC of the breast is a rare type of breast cancer, representing less than 0.1% of breast malignancies (Lakhani et
al., 2012). ACC of the breast occurs between 19 and 97 years of age and more common in women in their fifth
and sixth decade of life (Canyilmaz et al., 2014). 338 cases of breast adenoid cystic carcinoma in the past 30 years
were analyzed, and the age-adjusted incidence rate was determined to be 0.92 / 100 million person / year. Blacks
were 39 percent less likely than whites' morbidity (Ghabach et al., 2010). Most cases are female, but occasionally
there are male cases reported (Tang et al., 2015), and domestic literatures report less.
2 Clinical Manifestations
Most of the patients were characterized by a single, well-defined tumor, but there were also a few cases of the
multifocal breast of ACC reported (Franceschini et al., 2010)
.
Other rare symptoms include breast pain and nipple
depression. Most patients´ lesions occur in the areola area or upper outer quadrant. Tumour size is variable with an
average of 2-3 cm and up to 15 cm. (
Defaud-Henon et al., 2010
). Preoperative fine-needle aspiration cytology can
be useful for the diagnosis (
Boujelbene et al., 2012
). Mammography X-ray and ultrasound and other imaging
studies are all lacking specificity and may be misdiagnosed as benign lesions (Glazebrook et al., 2010).
3 Pathology
3.1 Naked eye view
Most cases are macroscopically well-circumscribed. Occasionally, pink, tan, or gray microcysts are evident. ACC
usually presents as a localized disease of pathologic T1 or T2 (
Miyai et al., 2014
).
