Abstract Breast cancer is the most common cancer in women. The primary types are ductal and lobular carcinomas. Adenoid cystic carcinoma is an extremely rare form of breast cancer, comprising only 0.1 % of cases. It is also unique in its seemingly favorable prognosis and lack of axillary lymph node involvement. A significant portion of cases are estrogen receptor (ER) negative, progesterone receptor (PR) negative, and human epidermal growth factor 2 (HER2-neu) negative. We present the case of a 68-year-old female with a past medical history of right sided adenoid cystic breast carcinoma that was originally diagnosed in 2016. She underwent neoadjuvant therapy with doxorubicin, cyclophosphamide every fourteen days for four cycles followed by a paclitaxel treatment regimen. After this, she underwent a right-sided mastectomy with sentinel lymph node sampling and removal of 3 lymph nodes. Her lymph nodes were negative, making her post surgical stage T2N0. Of note, she was ER-/PR-/HER2-neu-. She underwent routine yearly mammography without recurrence. Nine years later, before she was due for her mammogram, she developed a persistent cough and was ultimately found to have multiple pulmonary nodules, with the largest measuring 1.1 cm in the left upper lobe (LUL) on a computed tomography (CT) scan of her lungs. Shortly after, she underwent robotic bronchoscopy with fine needle aspiration, cryobiopsy of two large nodules including that of the LUL, and endobronchial ultrasound (EBUS) lymph node sampling. Her cryobiopsy of the LUL nodule returned as adenoid cystic carcinoma and was negative on lymph node biopsy. Subsequent positron emission tomography (PET) CT scan for staging did not reveal any evidence of distant disease. Overall, there is little data on this type of carcinoma and thus, there is no specialized consensus on treatment. Most of the data consists of case reports, which is why it is so important to highlight the rare occurrences of this disease. The lungs seem to be the most common location of metastasis, consistent with our patient, making its recognition a necessity. Eventually, with enough characterization and information gathered regarding the histopathologic nature, the genetic components, and the behavior of this cancer; there could be a role for broadened surveillance imaging. Given its high rate of recurrence and propensity for lung metastasis, we propose yearly low-dose CT scan of the chest in addition to mammography for women specifically diagnosed with adenoid cystic carcinoma post treatment. This abstract is funded by: none
Samuel et al. (2026) studied this question.