A case of adenoid cystic carcinoma of the breast

Locally Advanced Adenoid Cystic Carcinoma of the Breast-A Case Report with a Review of the Literature

Breast cancer (BC) is a heterogeneous disease distinguished by four main subtypes based on the expression of estrogen, progesterone receptors, and human epidermal growth factor-2 on the cancer cells. Triple-negative breast cancer (TNBC) consists of approximately 10-20% of all BCs and is characterized by a poor prognosis. Adenoid cystic carcinoma (ACC) of the breast is a rare, special type of TNBC with low metastatic potential and usually favorable prognosis. There are no established recommendations concerning systemic therapy in advanced ACC. We present a case of a 70-year-old woman with locally advanced ACC with progression after radical mastectomy, and review the literature concerning the treatment of metastatic disease focused on systemic therapy.

Triple negative breast cancer: special histological types and emerging therapeutic methods

Triple negative breast cancer (TNBC) is a complex and malignant breast cancer subtype that lacks expression of the estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2), thereby making therapeutic targeting difficult. TNBC is generally considered to have high malignancy and poor prognosis. However, patients diagnosed with certain rare histomorphologic subtypes of TNBC have better prognosis than those diagnosed with typical triple negative breast cancer. In addition, with the discovery and development of novel treatment targets such as the androgen receptor (AR), PI3K/AKT/mTOR and AMPK signaling pathways, as well as emerging immunotherapies, the therapeutic options for TNBC are increasing. In this paper, we review the literature on various histological types of TNBC and focus on newly developed therapeutic strategies that target and potentially affect molecular pathways or emerging oncogenes, thus providing a basis for future tailored therapies focused on the mutational aspects of TNBC.

Mammary adenoid cystic carcinoma presenting with Ductal carcinoma in situ and axillary lymph node metastasis

Mammary adenoid cystic carcinoma (ACC) is extremely rare tumors, comprising <0.1% of all breast cancers. Moreover, lymph node metastasis is <2% of mammary ACC. Here, we report a case of 51-year-old female presented with painful mass on her left breast and left axillary lymph node enlargement. Core needle biopsy revealed invasive ductal carcinoma. Left lumpectomy and axillary lymph nodes dissections were performed. The final pathological report showed triple-negative mammary ACC arising with high grade ductal carcinoma in situ (DCIS) and axillary lymph node metastasis. Immunohistochemistry study is useful in confirming a diagnosis. Given the rarity of this cancer, natural history of disease is still not clearly understood. Complete surgical excision is the mainstay of treatment. To our best knowledge, mammary ACC presenting with DCIS and axillary lymph node metastasis has never been reported and should be considered in the differential diagnosis of breast cancers.