Adenoid cystic carcinoma of the breast- A focused review

Adenoid cystic carcinoma [ACC] is the most common malignant epithelial tumor of the minor salivary glands and is characterized by the presence of a dual population of both epithelial/luminal and myoepithelial/basaloid (abluminal) cell proliferation. Rarely, ACC is detected outside of the salivary glands in locations including the uterine cervix, bartholin’s glands, lacrimal glands, auditory canal, skin, upper respiratory tract and lung, kidney, esophagus, prostate, and breast. Adenoid cystic carcinoma of the breast is rare, with an incidence of ~1/1 million female-years, a rate that has remained stable since the 1980s despite increases in mammogram screening. These tumors usually occur in Caucasian women, though rarely this tumor has also been reported in the male breast. This talk will provide a focused review on the clinical features, radiological findings, and key pathological features including the unique immunohistochemical staining properties with a brief purview on the differential diagnosis. The controversial views on its histopathogenesis will be explored including the underlying molecular mechanisms. Similarities and differences to salivary gland tumors will be highlighted. Best practice management and the role for surgery, radiotherapy, chemotherapy and hormonal therapy will be discussed. This talk will conclude with an update on the prognostic and predictive factors of this unique breast tumor.

Author(s): Rani Kanthan

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