Marco Vicente, Garcia Felip, Rubio Isabel T, Soler Teresa, Ferrazza Laura, Roig Ignasi, Mendez Inmaculada, Andreu Xavier, Mínguez Clarisa González, Tresserra Francesc
Hospital Quironsalud Barcelona, Pathology, Barcelona, Spain.
Hospital Quironsalud Barcelona, Pathology, Barcelona, Spain.
Rev Esp Patol. 2021 Oct-Dec;54(4):242-249. doi: 10.1016/j.patol.2020.09.005. Epub 2020 Dec 31.
Adenoid cystic carcinoma of the breast (ACCB) is a rare triple negative tumor (TNT) with an excellent prognosis in most cases. Three different histologic types are recognized: classic ACCB, solid basaloid ACCB (SB-ACCB), and ACCB with high-grade transformation. A majority of these tumors show characteristic molecular and immunohistochemical (IHC) features, with fusion of MYB and NFIB genes and overexpression of MYB, respectively. Basaloid carcinomas of the breast (BCB) are infrequently described. They resemble SB-ACCB and TNT of no special type (TNT-NST). We have studied the clinicopathological features of 17 ACCB and 9 BCB, investigating the expression of MYB by IHC and the rearrangements of MYB by fluorescence in situ hybridization (FISH). MYB was expressed by IHC in 15 ACCB and in 3 BCB. MYB FISH detected rearrangements in 11 ACCB and in 2 BCB. After a mean follow-up of 90 months, with a range of 12-204 months, 2 patients with ACCB with high-grade transformation and 1 patient with BCB developed metastases and died of disease. In summary, most ACCB have a good prognosis, but tumors with adverse histopathological features may metastasize. BCB may overlap with ACCB and TNT-NST, and their prognosis should be further studied.
乳腺腺样囊性癌（ACCB）是一种罕见的三阴性肿瘤（TNT），多数情况下预后良好。目前已确认三种不同的组织学类型：经典型ACCB、实体基底样ACCB（SB - ACCB）和伴有高级别转化的ACCB。这些肿瘤大多数具有特征性的分子和免疫组化（IHC）特征，分别为MYB和NFIB基因融合以及MYB过表达。乳腺基底样癌（BCB）鲜有描述。它们类似于SB - ACCB和非特殊类型的三阴性乳腺癌（TNT - NST）。我们研究了17例ACCB和9例BCB的临床病理特征，通过免疫组化检测MYB的表达，并通过荧光原位杂交（FISH）检测MYB的重排。免疫组化显示15例ACCB和3例BCB表达MYB。FISH检测到11例ACCB和2例BCB存在重排。平均随访90个月（范围12 - 204个月）后，2例伴有高级别转化的ACCB患者和1例BCB患者发生转移并死于疾病。总之，大多数ACCB预后良好，但具有不良组织病理学特征的肿瘤可能发生转移。BCB可能与ACCB和TNT - NST重叠，其预后有待进一步研究。
