Multifocal adenoid cystic carcinoma of the breast: not always a quiet course

Adenoid cystic carcinoma (ACC) of breast is a fairly uncommon malignancy, accounting for 0.1% of all cases of breast carcinomas. Though ductal or lobular breast carcinomas can be multifocal/multicentric examples of the multifocal breast ACC is sparse. Hereby we report a case of retro-areolar multifocal ACC of the breast in a 36 year old female with typical grade 1 histomorphology. Characterization is important as ACC breast has an excellent prognosis with little chance of lymph node and distant metastases. However, our case metastasized after undergoing wide local excision. This example reminds both the physician and pathologist to consider ACC in the differential diagnosis of retroareolar multicentric/multifocal breast carcinoma and the importance of mastectomy with axillary clearance in all histological grades.

The Sri Lanka Journal of Surgery 2015; 33(3): 18-19