The clinical behavior and genomic features of the so-called adenoid cystic carcinomas of the solid variant with basaloid features

Solid-basaloid variant of adenoid cystic carcinoma of the breast with near complete response to neoadjuvant chemotherapy

“…While none of the patients in their series had evidence of local recurrence or distant metastases despite a follow up period of up to 7.3 years (mean 32 months), the data presented in that study suggested that SB-AdCC had a higher propensity for lymph node metastases than C-AdCC. Subsequent studies confirmed this observation, which lead to the recommendation for routine axillary staging in these patients, and also noted more aggressive clinical behavior 3,6,8 . In the largest series reported to date, Schwartz et al 6 compared the clinicopathologic features and follow-up data of 29 SB-AdCC and 75 C-AdCC from MSK.…”

“…Subsequent studies confirmed this observation, which lead to the recommendation for routine axillary staging in these patients, and also noted more aggressive clinical behavior 3,6,8 . In the largest series reported to date, Schwartz et al 6 compared the clinicopathologic features and follow-up data of 29 SB-AdCC and 75 C-AdCC from MSK. SB-AdCCs had significantly higher histologic grade, higher rates of lymphovascular invasion and lymph node metastases, and were more likely to recur locally and develop distant metastatic disease.…”

“…In the cohort described by ref. 6 , the surgical approach and use of adjuvant radiotherapy were similar between the variants, however patients with SB-AdCC were significantly more likely to receive adjuvant chemotherapy than C-AdCC (68.4% versus 17.3%, respectively). Despite this, DFS was significantly reduced in patients with SB-AdCC, with a median DFS of 46.5 months for SB-AdCC versus 151.8 months in those with C-AdCC.…”

“…The solid basaloid variant of AdCC (SB-AdCC) is composed of cells with scant cytoplasm, marked nuclear atypia and increased mitotic activity 2 . In contrast to the classic form of AdCC (C-AdCC), which typically follows a relatively indolent course, the SB-AdCC variant has an aggressive clinical behavior [2][3][4] . Vanishingly rare (there are less than 100 published cases of SB-AdCC), currently there are no standardized recommendations regarding management.…”

“…Vanishingly rare (there are less than 100 published cases of SB-AdCC), currently there are no standardized recommendations regarding management. In the limited series available, most patients were treated with surgical excision and post-operative radiation but adjuvant chemotherapy was often omitted, similar to the management of C-AdCC [5][6][7] . At present, there is a paucity of data on chemotherapy benefit for SB-AdCC and its response to neoadjuvant treatment is unknown.…”