![]() ![]() Differences between HR+ ACC and HR- ACC with regard to clinicopathological features were evaluated using the chi-square test, and P < 0.05 was considered statistically significant in all the analyses. Three histological grades were determined according to WHO classification: Grade I, tumors with tubular and cribriform areas, but without solid components grade II, cribriform tumors that were either pure or mixed with 30% solid patterns.ĭescriptive statistics are reported as frequencies and percentages. HER2 status was defined as positive if scored as 3+ on immunohistochemistry or if fluorescence in situ hybridization demonstrated gene amplification. In this study, ER status was determined by immunohistochemistry and defined as positive with a cut-off of 1%. We summarized the clinical and pathological data (age, sex, tumor size, tumor location, immunohistochemical features), management (surgical, chemotherapy, endocrine therapy, and radiation), estrogen and progesterone receptor status, and prognostic information of 14 patients with ACC and conducted statistical analysis. Among these patients, a total of 14 patients were pathologically diagnosed with adenoid cystic carcinoma of the breast. To the best of our knowledge, this study is one of the few that focuses on ACC with HR+ status.įrom January 2000 to December 2017, a retrospective analysis revealed that 23,205 patients were diagnosed with breast cancer and surgically treated at XXX. We also describe the clinicopathological features of HR+ ACC and compare them with those of HR- breast ACC. At the same time, we assessed the utility of FNAC in the diagnosis of ACC of the breast. This study presents the clinical manifestations, imaging characteristics, pathological findings, and surgical and oncological outcomes of breast ACC in patients seen at a single institution. As a result, no consensus exists on the optimal therapy. One major obstacle when optimizing the therapeutic management of ACC is the rarity of the tumor. Compared with ACC with negative HR expression, the clinical characteristics and prognosis of this type of ACC are also unknown. The significance of a positive hormone receptor status is not known. ![]() ![]() In addition, some studies have also reported some HR-positive ACC cases ( 5). As prognosis is good, accurate preoperative diagnosis is important in the determination of suitable treatment. However, the prognosis of ACC of the breast is usually better than that of other triple-negative breast cancers ( 4, 11). Histologically, ACC of the breast typically consists of a dual-cell population of luminal and myoepithelial-basal cells, which are generally negative for estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) ( 2, 10). Nevertheless, these clinical and radiographic features may be similar to any breast cancer, thus making their precise diagnosis difficult for radiologists ( 2). On mammography, the case may present as a lobulated mass with sharp or unsharp margins ( 8). Ultrasound features are those of a hypoechoic solid or heterogeneous mass. ACC of the breast has no characteristic imaging findings. Most ACCs are located under the areola or in the upper outer quadrants ( 4, 8, 9). The typical clinical feature is a single mass of the breast, and multiple nodules are rare. However, occasional cases have been reported in male patients ( 6, 7). Most cases are in females, and the median age of onset is between 50 and 60 years old ( 4, 5). Local recurrence occurred in 14.3% of patients, 1.7% of patients had distant metastasis, all patients with local recurrence or distant metastasis were in the HR (-) group, and all patients were alive at the last follow-up.Īdenoid cystic carcinoma (ACC) of the breast is a rare special histological type of breast cancer, accounting for approximately 0.1% of all breast tumors ( 1– 3). There was no significant difference in clinicopathological characteristics between the HR+ group and the HR- group (P>0.05). The remaining patients were hormone receptor positive (HR+). Eight/14 (57.1%) patients were hormone receptor negative (HR−) and HER-2/neu (−) (HER2−). Median tumor size was 1.75 cm (range, 1–3 cm). All 14 patients underwent surgery, and no patient had a positive lymph node status. Six patients (42.9%) were suspected of having ACC by fine-needle aspiration cytology (FNAC) and were confirmed by postoperative histology and immunohistochemistry. The most common clinical presentation was a palpable mass (85.7%), and the imaging characteristics of all patients on color Doppler ultrasound and mammography were nonspecific. All but three patients were postmenopausal, with a median age at diagnosis of 60.5 years (range, 39–73 years). Fourteen patients were diagnosed with ACC of the breast, out of 23205 total patients treated for breast cancer (0.06%). ![]()
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