Primary breast adenoid cystic carcinoma — insights from a 4-case series

Introduction. Adenoid cystic carcinoma (AdCC) of the breast is a rare, slow-growing yet locally aggressive malignancy, often exhibiting a triple-negative immunophenotype. This study evaluated the clinical and pathological aspects of primary breast AdCC in a cohort of four cases. Material and methods. We conducted an extensive review of medical and pathological records of breast cancer (BC) patients treated between 2012 and 2024. Results. Four female patients with a median age at diagnosis of 60 years, presenting with stage T1 or T2 and confirmed diagnoses of breast AdCC were identified. Two cases presented triple-negative phenotype, two had positive hormonal receptor status. All patients had breast conserving surgeries. The first patient was offered systemic treatment. The second patient underwent systemic treatment and later developed metastases. The third patient received adjuvant radiotherapy. The fourth patient received hormonal therapy and subsequently underwent radiation therapy. Conclusions. Breast AdCC presents diagnostic and therapeutic challenges, with immunohistochemistry crucial for diagnosis. Further assessment of BCT, lymph node dissection, and adjuvant therapy is needed.