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WHO Classification of Tumours
Adenoid cystic carcinoma
Breast


Definition

Adenoid cystic carcinoma (ACC) of the breast is a rare carcinoma with low aggressive potential. It usually presents as a circumscribed, microcystic nodule measuring from 0.7 to 12 cm (average 3 cm)
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Rosen PP (1989)
Adenoid cystic carcinoma of the breast. A morphologically heterogeneous neoplasm.
Pathol Annu 24 Pt 2: 237-54



. A central core of neoplastic cells is surrounded by areas of invasion. The stroma may appear normal, desmoplastic, myxoid or adipose. The tumour architecture is characterized by three basic patterns: trabecular-tubular, cribriform, and solid. The bulk of the tumour consists of basaloid cells with myoepithelial features, scanty cytoplasm, round to ovoid nuclei and 1-2 nucleoli. The glandular lumina are lined by cuboidal to spindle-shaped cells with eosinophilic cytoplasm. Approximately 15% of tumours contain sebacous elements
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Tavassoli FA, Norris HJ (1986)
Mammary adenoid cystic carcinoma with sebaceous differentiation. A morphologic study of the cell types.
Arch Pathol Lab Med 110: 1045-53



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Virtually all ACCs are estrogen- and progesterone-receptor negative.
Adenoid cystic carcinoma affect predominantly women >40 years of age. Simple mastectomy is generally curative. Incomplete excision may result in local recurrence. Spread via the lymphatic stream is rare. About 10% of cases develop distant metastases, frequently to the lungs

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Tavassoli FA, Devilee P (Eds.)
World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Breast and Female Genital Organs.
3rd Edition
IARC Press: Lyon 2003



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