Zhang Yibo, Li Xidie, Xue Yaxi, Huang Xiaohui, An Fengxian, Tan Miduo
Department of Ultrasonography, The Hunan Province Directly Affiliated TCM Hospital, Zhuzhou, Hunan, China.
Department of Obstetrics and Gynecology, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou, Hunan, China.
Front Oncol. 2025 Apr 22;15:1565175. doi: 10.3389/fonc.2025.1565175. eCollection 2025.
To present a rare case of adenoid cystic carcinoma of the breast (ACCB), solid subtype, with multiple distant metastases, and to analyze its clinical management and differentiation from typical triple-negative breast cancer (TNBC), highlighting the lack of standardized guidelines for this rare entity and providing insights for future therapeutic strategies.
A 46-year-old female with ACCB was followed for 9 years, documenting metastatic progression, treatment responses, and survival outcomes. A literature review was conducted to compare ACCB and TNBC in terms of clinicopathological features, immunohistochemical profiles, metastatic patterns, and therapeutic strategies.
The patient exhibited aggressive behavior with metastases to the brain, lungs, liver, and kidneys. Systemic chemotherapy (albumin-bound paclitaxel and capecitabine) combined with radiotherapy stabilized the disease, achieving a 9-year survival with preserved quality of life.
ACCB requires differentiation from TNBC due to its unique biological behavior and favorable prognosis. Breast-conserving surgery with radiotherapy may be preferable for localized disease, while systemic chemotherapy should be considered for metastatic solid subtypes. This case underscores the urgent need for consensus guidelines and further research on molecular profiling to refine therapeutic approaches.
报告一例罕见的乳腺腺样囊性癌（ACCB）实性亚型伴多发远处转移的病例，并分析其临床管理以及与典型三阴性乳腺癌（TNBC）的鉴别，强调针对这种罕见实体缺乏标准化指南，并为未来治疗策略提供见解。
对一名患有ACCB的46岁女性进行了9年的随访，记录转移进展、治疗反应和生存结果。进行文献综述以比较ACCB和TNBC在临床病理特征、免疫组化谱、转移模式和治疗策略方面的差异。
该患者表现出侵袭性病程，出现脑、肺、肝和肾转移。全身化疗（白蛋白结合型紫杉醇和卡培他滨）联合放疗使病情稳定，实现了9年生存且生活质量得以保留。
由于ACCB独特的生物学行为和良好的预后，需要将其与TNBC进行鉴别。对于局限性疾病，保乳手术联合放疗可能更可取，而对于转移性实性亚型应考虑全身化疗。该病例强调了迫切需要达成共识指南并进一步开展分子谱研究以优化治疗方法。
