A rare case of recurrent adenoid cystic carcinoma of the breast with weak hormone receptor positivity

Adenoid cystic carcinoma (ACC) of the breast is an exceptionally rare malignancy, accounting for less than 0.1% of all breast cancers. Despite its favorable prognosis, optimal management remains undefined due to its rarity and lack of consensus guidelines. We report a case of recurrent ACC of the br...

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Main Authors: Jonathan W. Ray, MD, Mena Louis, DO, Nathaniel Grabill, MD, Jaime Morel Ruiz, MD, Priscilla Strom, MD
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Radiology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S1930043324013797
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author Jonathan W. Ray, MD
Mena Louis, DO
Nathaniel Grabill, MD
Jaime Morel Ruiz, MD
Priscilla Strom, MD
author_facet Jonathan W. Ray, MD
Mena Louis, DO
Nathaniel Grabill, MD
Jaime Morel Ruiz, MD
Priscilla Strom, MD
author_sort Jonathan W. Ray, MD
collection DOAJ
description Adenoid cystic carcinoma (ACC) of the breast is an exceptionally rare malignancy, accounting for less than 0.1% of all breast cancers. Despite its favorable prognosis, optimal management remains undefined due to its rarity and lack of consensus guidelines. We report a case of recurrent ACC of the breast, illustrating treatment challenges and the need for individualized management. A 64-year-old woman presented with a palpable mass in her left breast; imaging and biopsy confirmed ACC with very poor hormone receptor positivity. She started neoadjuvant chemotherapy but discontinued after 3 cycles due to severe neutropenia and lack of response. She then underwent breast-conserving surgery and radiotherapy. Three years later, she developed a local recurrence. Imaging and biopsy reconfirmed ACC and a subsequent total mastectomy achieved clear margins. Local recurrence of breast ACC can occur despite chemotherapy, surgery, and radiotherapy. Ineffectiveness of chemotherapy and recurrence after breast-conserving surgery suggest mastectomy might offer better local control. Hormone receptor positivity raises considerations for hormonal therapy, not standard for typically triple-negative ACC. The rarity of ACC complicates establishing standard protocols, necessitating personalized treatment plans based on tumor and patient factors. Recurrent breast ACC presents management challenges due to rarity and unpredictable behavior. More aggressive surgery and tailored treatment may improve outcomes. Further research is essential to develop evidence-based guidelines for managing this rare carcinoma.
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spelling doaj-art-03176e7e3c4d4220b8389e456fda55b82025-01-18T05:04:07ZengElsevierRadiology Case Reports1930-04332025-03-0120315951600A rare case of recurrent adenoid cystic carcinoma of the breast with weak hormone receptor positivityJonathan W. Ray, MD0Mena Louis, DO1Nathaniel Grabill, MD2Jaime Morel Ruiz, MD3Priscilla Strom, MD4Northeast Georgia Medical Center, General Surgery Department, 743 Spring Street NE, Gainesville, GA 30501, USANortheast Georgia Medical Center, General Surgery Department, 743 Spring Street NE, Gainesville, GA 30501, USANortheast Georgia Medical Center, General Surgery Department, 743 Spring Street NE, Gainesville, GA 30501, USA; Corresponding author.Northeast Georgia Medical Center, Pathology Department, 743 Spring Street NE, Gainesville, GA 30501, USALongstreet Clinic, Breast Surgery, 725 Jesse Jewell Parkway, Gainesville, GA 30501 USAAdenoid cystic carcinoma (ACC) of the breast is an exceptionally rare malignancy, accounting for less than 0.1% of all breast cancers. Despite its favorable prognosis, optimal management remains undefined due to its rarity and lack of consensus guidelines. We report a case of recurrent ACC of the breast, illustrating treatment challenges and the need for individualized management. A 64-year-old woman presented with a palpable mass in her left breast; imaging and biopsy confirmed ACC with very poor hormone receptor positivity. She started neoadjuvant chemotherapy but discontinued after 3 cycles due to severe neutropenia and lack of response. She then underwent breast-conserving surgery and radiotherapy. Three years later, she developed a local recurrence. Imaging and biopsy reconfirmed ACC and a subsequent total mastectomy achieved clear margins. Local recurrence of breast ACC can occur despite chemotherapy, surgery, and radiotherapy. Ineffectiveness of chemotherapy and recurrence after breast-conserving surgery suggest mastectomy might offer better local control. Hormone receptor positivity raises considerations for hormonal therapy, not standard for typically triple-negative ACC. The rarity of ACC complicates establishing standard protocols, necessitating personalized treatment plans based on tumor and patient factors. Recurrent breast ACC presents management challenges due to rarity and unpredictable behavior. More aggressive surgery and tailored treatment may improve outcomes. Further research is essential to develop evidence-based guidelines for managing this rare carcinoma.http://www.sciencedirect.com/science/article/pii/S1930043324013797Adenoid cystic carcinomaBreast cancerRecurrenceMastectomyHormone receptor positivity
spellingShingle Jonathan W. Ray, MD
Mena Louis, DO
Nathaniel Grabill, MD
Jaime Morel Ruiz, MD
Priscilla Strom, MD
A rare case of recurrent adenoid cystic carcinoma of the breast with weak hormone receptor positivity
Radiology Case Reports
Adenoid cystic carcinoma
Breast cancer
Recurrence
Mastectomy
Hormone receptor positivity
title A rare case of recurrent adenoid cystic carcinoma of the breast with weak hormone receptor positivity
title_full A rare case of recurrent adenoid cystic carcinoma of the breast with weak hormone receptor positivity
title_fullStr A rare case of recurrent adenoid cystic carcinoma of the breast with weak hormone receptor positivity
title_full_unstemmed A rare case of recurrent adenoid cystic carcinoma of the breast with weak hormone receptor positivity
title_short A rare case of recurrent adenoid cystic carcinoma of the breast with weak hormone receptor positivity
title_sort rare case of recurrent adenoid cystic carcinoma of the breast with weak hormone receptor positivity
topic Adenoid cystic carcinoma
Breast cancer
Recurrence
Mastectomy
Hormone receptor positivity
url http://www.sciencedirect.com/science/article/pii/S1930043324013797
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