Fernández de Los Reyes Irene, Córdoba Iturriagagoitia Alicia, Chouza Sanin Mateo, Aguiar Losada Begoña, Larrea Ramirez Alba, Ruíz de Azúa Ciria Yerani
Departamento de Anatomía Patológica, Complejo Hospitalario de Navarra, Pamplona, España.
Departamento de Anatomía Patológica, Complejo Hospitalario de Navarra, Pamplona, España.
Rev Esp Patol. 2020 Oct-Dec;53(4):206-212. doi: 10.1016/j.patol.2020.06.003. Epub 2020 Jul 24.
Adenoid cystic carcinoma (ACC) is an uncommon neoplasm in the breast (less than 0.1%). ACC is typically triple negative with a favourable prognosis. Its low frequency and indolent course cause difficulties in the agreement of the evaluation and therapeutic consensus, as well as the use of the sentinel node excision in these carcinomas.
Our goal is to provide a new series of cases from the Complejo Hospitalario de Navarra, through retrospective review over a period of 22 years.
Every case of breast ACC diagnosed between 1998-2020 is reviewed. We analyze the clinical and pathological characteristics, and compare them with the literature.
We identified twelve cases of ACC, from a total of 18,241 patients diagnosed with breast carcinoma, with an average tumor size of 23.8mm and mean of 63.5 years. All of them were in a stage I-II at diagnosis. One case presented a lymph node micrometastases. One of them presented local recurrences and one case presented metastases 5 months after diagnosis (93.5 months of mean follow-up). According to Nottingham Histological Score, eight cases had a grade 1, two grade 2 and two grade 3. According to the classification of Ro et al., three were grade 1, four grade 2 and five grade 3. One case was ER positive (10%). No case presents positivity for BRAF-V600E in immunohistochemistry.
The management and prognosis ACC of breast, within benignity, remains uncertain, with more studies being needed to understand the clinical evolution and perform adequate therapeutic management.
腺样囊性癌(ACC)是一种罕见的乳腺癌(占比不到0.1%)。ACC通常为三阴性,预后良好。其发病率低且病程进展缓慢,这使得在评估和治疗共识的达成以及在这些癌症中使用前哨淋巴结切除方面存在困难。
我们的目标是通过对22年期间的回顾性研究,提供来自纳瓦拉综合医院的一系列新病例。
回顾1998年至2020年间诊断的每一例乳腺ACC病例。我们分析其临床和病理特征,并与文献进行比较。
在总共18241例诊断为乳腺癌的患者中,我们识别出12例ACC病例,平均肿瘤大小为23.8mm,平均年龄为63.5岁。所有病例在诊断时均处于I-II期。1例出现淋巴结微转移。其中1例出现局部复发,1例在诊断后5个月出现转移(平均随访93.5个月)。根据诺丁汉组织学评分,8例为1级,2例为2级,2例为3级。根据Ro等人的分类,3例为1级,4例为2级,5例为3级。1例雌激素受体(ER)阳性(10%)。免疫组化中没有病例出现BRAF-V600E阳性。
乳腺ACC的管理和预后在良性范围内仍不确定,需要更多研究来了解其临床演变并进行适当的治疗管理。