PRACTICE & PROTOCOLS

BENIGN / BORDERLINE

Special Types of Breast Carcinoma (2)

Adenoid Cystic Carcinoma

This is a core biopsy of a recurrent lesion first diagnosed six years previously:

Low power view (x 1.25) of core biopsy of adenoid cystic carcinoma

Core biopsy - adenoid cystic carcinoma

Core biopsy - adenoid cystic carcinoma

Clinical Features

Analagous to same pattern of tumour seen in salivary glands and elsewhere
Very uncommon in the breast
Often peri-areolar
Patients usually post-menopausal

Often circumscribed
Tumour cells infiltrate as cribriform aggregates or trabeculae
Basaloid and ductal cell types discernible with difficulty on H&E
AB/PAS stain and CK7 immunostaining helps to highlight ductal pattern cells
Usually ER & PGR negative

Differential Diagnosis

Invasive cribriform carcinoma:

Cribriform carcinomas are uniformly CK7 positive as opposed to focally positivity in adenoid cystic carcinoma
Cribriform carcinomas are invariably strongly ER positive

Usually excellent
There is a very low risk of axillary or distant metastasis

Selected views of above core biopsy including histochemistry and immuno
Click on images for further detail

Core biopsy - adenoid cystic carcinoma

Core biopsy - adenoid cystic carcinoma

Core biopsy - adenoid cystic carcinoma

Core biopsy - adenoid cystic carcinoma

Core biopsy - adenoid cystic carcinoma - CK7 immunostain

Core biopsy - adenoid cystic carcinoma - AB/PAS stain

Core biopsy - adenoid cystic carcinoma - ER immunostain

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