Cancer Genetics and Epigenetics 2017, Vol.5, No.2, 6-10
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breast-conserving surgery cannot be achieved, it is recommended to use a breast resection with a higher grade of
invasive carcinoma (Miyai et al., 2014).
5.2 Axillary management
The frequency of axillary lymph node metastases is very low, around 0-2% (Boujelbene et al., 2012). Except for
the clinical evidence of axillary lymph node metastasis, axillary lymph node dissection is not recommended (Wei
et al., 2014). The preoperative clinical examination did not touch the lymph nodes and color Doppler ultrasound
exploration found no suspicious axillary lymph node metastasis, sentinel node biopsy is required, especially
combined with other types of invasive cancer, higher tumor grade or tumors larger than 3 cm (Thompson et al.,
2011).
5.3 Radiotherapy
The importance of radiotherapy after breast conserving surgery with ACC of breast has not been recognized until
recently. A large sample of studies in recent years showed that postoperative adjuvant radiotherapy improves
overall survival (Coates et al., 2010). Radiation therapy can significantly improve the 5-year local control rate of
the breast-conserving surgery group, and surgical margin or tumor involvement does not affect the treatment effect,
the curative effect of breast conserving surgery with postoperative adjuvant radiotherapy and simple mastectomy
is close. Therefore, regardless of how the margin is, it is recommended that local mastectomy with postoperative
adjuvant radiotherapy be performed to avoid mastectomy (Khanfir et al., 2012).
5.4 Chemotherapy
There are very few reports about breast of ACC chemotherapy. Some doctors recommend patients with axillary
lymph node metastasis and distant metastasis receive systemic adjuvant chemotherapy, and patients with higher
tumor grade or those with tumor size greater than 3 cm may also choose chemotherapy (Goldhirsch et al., 2011).
However, there is no unified conclusion on the efficacy of chemotherapy and the choice of specific chemotherapy
regimens in patients with breast of ACC.
5.5 Targeted therapy
With the development of targeted therapy, cancer therapy has entered a new stage, but there is still no targeted
therapy for breast of ACC into clinic. In recent years, the discovery and intensive study of the characteristic fusion
gene MYB-NFIB of adenoid cystic carcinoma have brought hope for molecular targeted therapy of breast adenoid
cystic carcinoma (Ding et al., 2015).
5.6 Endocrine therapy
The breast of ACC hormone receptor is negative and endocrine therapy is ineffective (Goldhirsch et al., 2011).
Few cases of endocrine therapy have been reported in the literature.
6 Prognosis
The contrast of ACC with other three negative breast and salivary gland ACC is characterized by good prognosis,
rare metastasis of lymph nodes and important organs (Li et al., 2012). The 10 year survival rate of breast of ACC
was 90%-100%. The most frequent site of metastasis is lung (Wei et al., 2014). When ACC patients have local
recurrence or distant metastasis, they still show a sustained and slow progression. Because a longer course of
disease increases the risk of recurrence and distant metastasis, the long term follow-up is required (Kim et al.,
2014).
Authors’ contributions
Z.D.W. read and approved the final manuscript. Z.Z.W. wrote the manuscript. Y.S.R. contributes to translation. Z.J.Y and Z.B.Z.
collected materials. All authors read and approved the final manuscript.
Acknowledgments
This work was supported by the Science Innovation Project (201613) and special fund for Excellent Academic Leader of Harbin
(2017RAXQJ076).
