Solid subtype of adenoid cystic carcinoma of the breast with multiple distant metastases: a case report and literature review

TL;DR

This case report describes a rare breast cancer subtype with distant metastases and long-term survival using combined treatment strategies.

Contribution

Highlights the distinct clinical behavior of solid adenoid cystic carcinoma of the breast compared to triple-negative breast cancer.

Findings

The patient survived 9 years with metastatic disease using chemotherapy and radiotherapy.

Solid adenoid cystic carcinoma of the breast shows unique metastatic patterns and treatment responses.

Breast-conserving surgery with radiotherapy is preferable for localized disease.

Abstract

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.

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