Adenomyoepithelioma of the Breast: A Report of 3 Cases

Abstract

Case series Patients: Female, 64-year-old • Female, 74-year-old • Female, 49-year-old Final Diagnosis: Breast adenomyoepithelioma Symptoms: Breast tumor Medication: — Clinical Procedure: — Specialty: Oncology • Pathology • Radiology • Surgery Objective: Rare disease Background: Breast adenomyoepithelioma is a rare benign breast tumor characterized by a biphasic proliferation of epithelial and myoepithelial cells with variable clinical and diagnostic features. Establishing the diagnosis, determining optimal therapy, and predicting outcome are problematic because of the rarity of this entity. There have been only 2 large series of adenomyoepitheliomas of the breast, reported by Tavassoli and Rosen, which included 27 and 18 patients, respectively. In this report, we present 3 cases of breast adenomyoepithelioma. Case Reports: Herein, we report 3 cases of breast adenomyoepithelioma. The first case is of a 64-year-old woman who was found to have right breast microcalcification on a screening mammogram. The second case is of a 74-year-old woman who had a right breast mass. These 2 patients were managed by wide local excision. Postoperative microscopic examination revealed adenomyoepithelioma. The third case is of a 49-year-old woman with bilateral saline breast implants who presented with a left breast mass. A core needle biopsy was done and revealed adenomyoepithelioma associated with usual ductal hyperplasia and ductal carcinoma in situ. Conclusions: Breast adenomyoepithelioma is a rare condition that can pose diagnostic challenges due to variable imaging presentations, necessitating percutaneous core biopsy for initial diagnosis. Correct diagnosis is usually possible only on excisional biopsy and confirmed by demonstrating the biphasic nature of the tumor by IHC. Clinical suspicion coupled with utilizing both radiological and histopathological facilities can aid in the accurate diagnosis and management. For the most part, they are considered to be benign, but they can locally recur.

Adenomyoepithelioma of the Breast in the Setting of Prior Contralateral Breast Malignancy

“…Diagnosis is often challenging given that clinical and radiologic presentations have been yet to be consistently described. Therefore, diagnosis requires pathology using percutaneous core biopsy for initial diagnosis and excisional biopsy for definitive diagnosis [ 3 , 4 , 7 ]. Immunohistochemistry is used to demonstrate biphasic proliferation of the surgical specimen [ 7 ].…”

“…Therefore, diagnosis requires pathology using percutaneous core biopsy for initial diagnosis and excisional biopsy for definitive diagnosis [ 3 , 4 , 7 ]. Immunohistochemistry is used to demonstrate biphasic proliferation of the surgical specimen [ 7 ].…”

“…Based on the current literature, complete surgical resection tends to be sufficient for benign AME, while malignant AME could require additional treatment with radiation or chemotherapy [ 3 ]. Clinicians agree that resection should be done with wide excision to reduce the risk of recurrence [ 7 ].…”

Concurrence of Adenomyoepithelioma of the Breast and Gastrointestinal Stromal Tumor of the Stomach: A Case Report and Review of the Literature

“…At the same time, in an Australian report, lesions were composed of round glands and solid clusters consisting of both epithelial and myoepithelial cells [ 9 ]. In contrast, AlQurashi et al and Laforga et al observed transformation into the apocrine metaplasia of the epithelial cells [ 12 , 24 ]. HER2 expression level is a well-established prognostic and predictive marker in invasive breast cancer.…”

“…Ductal carcinoma in situ (DCIS) is the malignant proliferation of cells of the basement membrane in the mammary duct. Past research has reported a few cases of the coexistence of AME with DCIS, and both conditions require surgical intervention with proper excision of the tumor [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ].…”