Objective: To investigate the clinicopathological characteristics of adenoid cystic carcinoma(ACC) in breast for improving the recognition and diagnosis of ACC. Method: Ten female patients with ACC were enrolled. Clinical symptoms and pathological characteristics were reviewed, immunohistochemical phenotyping of biopsies of ACC lesions were detected, and the related data were analyzed in combination with relevant references. Results: Patients were female, with mean age of (61±14) years. Six cases had lesions in left-breast and four cases in right, mostly in the upper outer quadrant. The main clinical manifestation was expansive growth, and the ACC tumor size ranged from 1 to 4 cm, and histologically resembled glandular, tubular and solid tumor. The tumor cells were immunohistochemically negative for ER, PR, HER-2 expression and positive for CD117 expression. Proliferation marker Ki67 ranged from 5%-30%. The median follow-up of these 9 cases ranged from 4-110 months. One patient died of multiple organ failure, and the other eight patients were alive and well with no evidence of disease. Conclusions: ACC of breast is a rare subtype of breast cancer and exhibits an indolent clinical behavior. ACC has its own special histologic characteristics, and differentiation with other breast benign and malignant tumor is needed.
[1] Ghabach B, Anderson WF, Curtis RE, et al.Adenoid cystic carcinoma of the breast in the United States (1977 to 2006): a population-based cohort study[J]. Breast Cancer Res,2010,12(4):R54.
[2] Stevens DA, Levine PH, Lee SK, et al.Concurrent infectious mononucleosisand acute leukemia. Case reports. Review of theliterature and serologic studies with the herpes-type virus (EB virus)[J]. Am J Med,1971,50(2):208-217.
[3] Ellis IO, Sehnitt SJ, SastreGarau X, et al. Invasive breastcarcinoma[M]//Tavassoli FA. Devilee P. World Health Organizationclassification of tumours. Pathology and genetics of turnouts of thebreast and female genital organs. Lyon:IARC Press,2003:4445.
[4] 《乳腺癌HER2检测指南(2014版)》编写组. 乳腺癌HER2检测指南(2014版)[J]. 中华病理学杂志,2014,43(4):262-266.
[5] Gnepp DR.Diagnositic surgical pathology of the head and neck[M]. 2nd ed. Philadelphia:Saunder Elsevier,2009:482-486.
[6] Ewing J.Epithelial tumors of the salivary gland, in neoplastic disease[M]. Philadelphia:WB Saunders,1919:780.
[7] Geschickter CK.Diseases of the breast, in diagnosis, pathology, treatment[M]. Philadelphia:JB Lippincott,1945:824.
[8] Yoo SJ, Lee DS, Oh HS, et al.Male breast adenoid cystic carcinoma[J]. Case Rep Oncol,2013,6(3):514-519.
[9] Kleer CG, Oberman HA.Adenoid cystic carcinoma of the breast: value of histologic grading and proliferative activity[J]. Am J Surg Pathol,1998,22(5):569-575.
[10] Miyai K, Schwartz MR, Divatia MK, et al.Adenoid cystic carcinoma of breast: Recent advances[J]. World J Clin Cases,2014,2(12):732-741.
[11] 刘红刚,高岩. WHO肿瘤分类头颈部肿瘤病理学和遗传学[M]. 北京:人民卫生出版社,2006:258-260.
[12] Szanto PA, Luna MA, Tortoledo ME, et al.Histologic grading of adenoid cystic carcinoma of the salivary glands[J]. Cancer,1984,54(6):1062-1069.
[13] Fukuoka K, Hirokawa M, Shimizu M, et al.Basaloid type adenoid cystic carcinoma of the breast[J]. APMIS,1999, 107(8):762-766.
[14] 魏丽娟, 梁晓峰, 李世霞, 等. 25例乳腺腺样囊性癌的临床分析[J]. 中华肿瘤杂志,2014,36(2):147-150.
[15] Tsuboi N, Ogawa Y, Inomata T, et al.Dynamic MR appearance of adenoid cystic carcinoma of the breast in a 67-year-old female[J]. Radiat Med,1998,16(3):225-228.
[16] Shin SJ, Rosen PP.Solid variant of mammary adenoid cystic carcinoma with basaloid features: a study of nine cases[J]. Am J Surg Pathol,2002,26(4):413-420.
[17] 周若骥, 胡春燕, 喻林, 等. 具有基底细胞样特征的乳腺实体型腺样囊性癌的临床病理学观察[J]. 中华病理学杂志,2012,41(12):803-807.
[18] Weigelt B, Horlings HM, Kreike B, et al.Refinement of breast cancer classification by molecular characterization of histological special types[J]. J Pathol,2008,216(2):141-150.
[19] Persson M, Andrén Y, Mark J, et al.Recurrent fusion of MYB and NFIB transcription factor genes in carcinomas of the breast and head and neck[J]. Proc Natl Acad Sci U S A,2009,106(44):18740-18744.
[20] van Dorpe J, De Pauw A, Moerman P. Adenoid cystic carcinoma arising in an adenomyoepithelioma of the breast[J]. Virchows Arch,1998,432(2):119-122.
[21] Boecker W, Buerger H.Evidence of progenitor cells of glandular and myoepithelial cell lineages in the human adult female breast epithelium: a new progenitor (adult stem) cell concept[J]. Cell Prolif,2003,36(Suppl 1):73-84.
[22] McLaren BK, Smith J, Schuyler PA, et al. Adenomyoepi-thelioma: clinical, histologic, and immunohistologic eva-luation of a series of related lesions[J]. Am J Surg Pathol,2005,29(10):1294-1299.
[23] 周营, 蔡杏娟, 戈少红, 等. 二甲双胍对糖尿病前期乳腺癌患者化学治疗期间血糖控制疗效和安全性的观察[J]. 内科理论与实践,2016,11(2):75-79.
[24] Harris GC, Pinder SE, O' Malley FP. Invasive carcinoma: Special types[M]// O'Malley FP, Pinder SE. Breast Pathology: A Volume in Foundations in Diagnostic Pathology Series. Philadelphia, PA:Churchill Livingstone Elsevier,2006:201-223.
[25] 童一苇, 陈小松, 沈坤炜. 乳腺癌多学科诊治现状及进展[J]. 外科理论与实践,2016,21(2):174-176.
[26] McClenathan JH, de la Roza G. Adenoid cystic breast cancer[J]. Am J Surg,2002,183(6):646-649.
[27] Koss LG, Brannan CD, Ashikari R.Histologic and ultrastructural features of adenoid cystic carcinoma of the breast[J]. Cancer,1970,26(6):1271-1279.
[28] Vranic S, Bender R, Palazzo J, et al.A review of adenoid cystic carcinoma of the breast with emphasis on its molecular and genetic characteristics[J]. Hum Pathol,2013, 44(3):301-309.
[29] Lakhani SR, Hayes M, Eusebi V.Adenomyoepithelioma andadenomyoepithelioma with carcinoma[M]// Lakhani SR, Ellis LO, Schnitt SJ, et al. WHO classification of tumours ofthe breast. 4th edition. Lyon:IARC,2012:122-123.
