Breast Disease Treatment Center, Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, China.
Gastrointestinal Diagnosis and Treatment Center, Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, China.
Medicine (Baltimore). 2024 Aug 23;103(34):e39461. doi: 10.1097/MD.0000000000039461.
Breast adenoid cystic carcinoma is an extremely rare tumor that is incompletely understood, accounting for less than <0.1% of all breast cancers, with an average diameter of 3 cm, and it is extremely rare to see a large, non-metastatic breast adenoid cystic carcinoma with a diameter of about 30 cm. Since this disease is extremely rare, there are few reports in the literature and limited data on clinical diagnosis and treatment. We present a case of a 71-year-old woman with a large, non-metastatic adenoid cystic carcinoma of the left breast and share our opinion on the diagnosis and treatment of this case.
A 71-year-old woman with a 20-year-old left breast mass with local bleeding and rupture for 1 hour presented to our hospital for further diagnosis and treatment. A computed tomography scan showed a large soft tissue mass shadow in the left breast and malignancy was considered. Subsequently, tissue aspiration pathology was performed and the results confirmed adenoid cystic carcinoma of the breast.
Intraoperative pathology results of radical mastectomy for left breast cancer diagnosed adenoid cystic carcinoma of the breast and immunohistochemistry results of triple-negative breast cancer.
Treatment of adenoid cystic carcinoma of the breast included neoadjuvant chemotherapy for breast cancer, radical mastectomy of the left breast, and postoperative chemotherapy. Initially, neoadjuvant chemotherapy for breast cancer was performed, and the TAC regimen was used to successfully reduce the size of the tumor and gain access to surgical treatment for breast cancer. The patient has recovered well after the surgery, with no wound infection or ulceration, and is now waiting for the patient's physical function to recover for postoperative chemotherapy, with no obvious discomfort.
Adenoid cystic carcinoma tumors are usually around 3 cm; such a huge 30 cm adenoid cystic carcinoma of the breast is extremely rare, and it is extremely rare to find a breast malignancy that has not developed regional lymph node and distant metastases for more than 20 years. Clinicians must remain vigilant for early breast malignancies at a high age of incidence and conduct further research for diagnosis to avoid delays.
乳腺腺样囊性癌是一种极其罕见的肿瘤，目前尚未完全了解，其发病率不足所有乳腺癌的 0.1%，平均直径为 3cm，直径约 30cm、无转移的乳腺腺样囊性癌极为罕见。由于该病极其罕见，文献报道较少，临床诊断和治疗的数据有限。我们报告了 1 例 71 岁女性左侧乳腺大、无转移的腺样囊性癌病例，并就该病例的诊断和治疗提出我们的观点。
1 名 71 岁女性，20 年前左乳出现肿块，1 小时前出现局部出血和破裂，来院进一步诊治。胸部 CT 扫描显示左乳腺内有一巨大软组织肿块影，考虑为恶性肿瘤。随后进行组织穿刺病理检查，结果证实为乳腺腺样囊性癌。
左侧乳腺癌根治术术中病理诊断为乳腺腺样囊性癌，免疫组化结果为三阴性乳腺癌。
乳腺腺样囊性癌的治疗包括乳腺癌新辅助化疗、左侧乳腺癌根治术和术后化疗。首先进行乳腺癌新辅助化疗，采用 TAC 方案成功缩小肿瘤体积，获得乳腺癌手术治疗机会。患者术后恢复良好，未出现伤口感染或溃疡，现等待患者身体功能恢复后进行术后化疗，无明显不适。
腺样囊性癌肿瘤通常约 3cm；如此巨大的 30cm 乳腺腺样囊性癌极为罕见，且如此巨大的乳腺恶性肿瘤在 20 多年内未发生区域淋巴结和远处转移的情况极为罕见。临床医生必须对高发年龄的早期乳腺癌保持警惕，进一步研究诊断方法，避免延误。
