Study on the Clinicopathological Characteristics of Adenoid Cystic Carcinoma of the Breast
Adenoid cystic carcinoma of the breast (BACC) is a rare type of invasive ductal breast cancer. The present study aimed to determine the clinicopathological characteristics of BACC in order to determine markers for accurate diagnosis and prognosis. A retrospective analysis of clinicopathological characteristics was conducted in 28 cases of BACC and 30 cases of nonspecific invasive breast cancer which served as the controls. All BACC patients were female, aged from 42 to 63 years. No lymph node metastasis, as well as nerve and lymphovascular invasion, was found in the BACC group. Twenty BACC cases showed classical tubular or cribriform structure, while eight other cases showed tumors of solid variant with obvious atypical cells that were proliferating with frequent mitosis. Epithelial and myoepithelial markers such as cytokeratin 7, CD117, epidermal growth factor receptor, and P63 were expressed in BACC cases. MYB was expressed in 26 BACC cases. Local recurrence happened in two BACC cases who were tested positive for nuclear protein 1 (NUPR1) during a 10 – 84-month follow-up. The expression of MYB and NUPR1 had a significant difference between the two groups (P < 0.001). In conclusion, the present study showed that BACC is associated with low invasive characteristics and relatively inert biological behavior on the account of the vast majority of BACC cases which were tested negative for NUPR1. The study also implied that NUPR1 is an indicator of poor prognosis of the tumor. Meanwhile, our study also corroborated the significance of MYB expression for its discriminatory role in BACC diagnosis and differential diagnosis. Therefore, these cases are generally not advocated for chemotherapy, but rather, they are expected to be treated with MYB-targeted therapy.
Weigelt B, Horlings HM, Kreike B, et al., 2008, Refinement of Breast Cancer Classification by Molecular Characterization of Histological Special Types. J Pathol, 216:141–50. DOI: 10.1002/path.2407.
Wetterskog D, Lopez-Garcia MA, Lambros MB, et al., 2012, Adenoid Cystic Carcinomas Constitute a Genomically Distinct Subgroup of Triple-Negative and Basal-Like Breast Cancers. J Pathol, 226:84–96. DOI: 10.1002/path.2974.
Narzt MS, Nagelreiter IM, Oskolkova O, et al., 2018, A Novel Role for NUPR1 in the Keratinocyte Stress Response to UV Oxidized Phospholipids. Redox Biol, 13:467–82. DOI: 10.1016/j.redox.2018.11.006.
Breast Cancer HER2 Testing Guideline (2019 Edition) Compilation Group, 2019, Breast Cancer HER2 Testing Guideline (2019 Edition). Chin J Pathol, 48:169–75.
Kasami M, Olson SJ, Simpson JF, et al., 1998, Maintenance of Polarity and a Dual Cell Population in Adenoid Cystic Carcinoma of the Breast: An Immunohistochemical Study. Histopathology, 32:232–8. DOI: 10.1046/j.1365-2559.1998.00383.x.
Bhutani N, Kajal P, Singla S, 2018, Adenoid Cystic Carcinoma of the Breast: Experience at a Tertiary Care Centre of Northern India. Int J Surg Case Rep, 51:204–9. DOI: 10.1016/j.ijscr.2018.08.035.
Agafonoff S, Sobolewski A, Braverman TS, 2019, Adenoid Cystic Carcinoma of the Breast Discordant Size on Imaging and Pathology: A Case Report and Review of Literature. Ann Med Surg (Lond), 43:1–4. DOI: 10.1016/j.amsu.2019.04.007.
Yang C, Zhang L, Sanati S, 2019, SOX10 is a Sensitive Marker for Breast and Salivary Gland Adenoid Cystic Carcinoma: Immunohistochemical Characterization of Adenoid Cystic Carcinomas. Breast Cancer (Auckl), 13:1–6. DOI: 10.1177/1178223419842185.
Ree AH, Tvermyr M, Engebraaten O, et al., 1999, Expression of a Novel Factor in Human Breast Cancer Cells with Metastatic Potential. Cancer Res, 59(:4675–80.
Jung SH, Lee A, Yim SH, et al., 2012, Simultaneous Copy Number Gains of NUPR1 and ERBB2 Predicting Poor Prognosis in Early-stage Breast Cancer. BMC Cancer, 12:1471–82. DOI: 10.1158/1538-7445.am2013-805.
Wang W, Zhao C, Liang Y, et al., 2016, Clinical Significance of Nuclear Protein 1/P8 Expression in Breast Cancer Tissues and its Relationship with Molecular Typing. Chin J Cancer Prev Treat, 23:436–40.
Baraban E, Zhang PJ, Jaffer S, et al., 2018, MYB Rearrangement and Immunohistochemical Expression in Adenomyoepithelioma of the Breast: A Comparison with Adenoid Cystic Carcinoma. Histopathology, 73:897–903. DOI: 10.1111/his.13708.
Poling JS, Yonescu R, Subhawong AP, et al., 2017, MYB Labeling by Immunohistochemistry is More Sensitive and Specific for Breast Adenoid Cystic Carcinoma than MYB Labeling by FISH. Am J Surg Pathol, 41:973–9. DOI: 10.1097/pas.0000000000000878.
Nicola F, Felipe CG, De Filippo MR, et al., 2016, Genetic Events in the Progression of Adenoid Cystic Carcinoma of the Breast to High-grade Triple-negative Breast Cancer. Mod Pathol, 29:1292–305.
Hodgson NC, Lytwyn A, Bacopulos S, et al., 2010, Adenoid Cystic Breast Carcinoma: High Rates of Margin Positivity after Breast Conserving Surgery. Am J Clin Oncol, 33:28–31. DOI: 10.1097/coc.0b013e31819fdfc8.
Slodkowska E, Xu B, Kos Z, et al., 2019, Predictors of Outcome in Mammary Adenoid Cystic Carcinoma: A Multi-Institutional Study. Am J Surg Pathol, 44:214–223. DOI: 10.1097/pas.0000000000001378.
Kashiwagi S, Asano Y, Ishihara S, et al., 2019, Adenoid Cystic Carcinoma of the Breast: A Case Report. Case Rep Oncol, 12:698–703. DOI: 10.1159/000502949.
Chen QX, Li JJ, Wang XX, et al., 2017, Similar Outcomes Between Adenoid Cystic Carcinoma of the Breast and Invasive Uctal Carcinoma: A Population-based Study From the SEER 18 Database. Oncotarget, 8:6206–6215. DOI: 10.18632/oncotarget.14052.
Liu X, Xu Y, Han L, et al., 2018, Reassessing the Potential of Myb-targeted Anti-cancer Therapy. J Cancer, 9(7):1259–66. DOI: 10.7150/jca.23992.