Adenoid Cystic Carcinoma of the Breast
Dear OncoLink "Ask the Experts,"
I am in search of information concerning Adenoid Cystic Carcinoma of the Breast, and for some type of protocol. My friend has this cancer. I am wondering if the anti-angiogenesis drugs, that are newly approved, would be beneficial for treatment of this rare breast cancer?
James P. Stevenson, MD, Section Editor for the OncoLink Medical Oncology/Chemotherapy Menu, responds:
Adenoid cystic carcinoma of the breast is rare (accounts for < 0.1% of breast cancers). Women with solitary tumors that are surgically resectable have a favorable prognosis. Local recurrences in the breast are the most common recurrence, and should be surgically removed. The most common site of distant disease is the lung, and this can occur years after removal of the primary.
The only treatment for women with metastatic disease is chemotherapy, and the combination of cisplatin (or carboplatin), carboplatin, and etoposide (VP-16) has been the best studied.
It's unclear from your question whether your friend just had a local tumor removed or if she has metastases. If it was a tumor that was surgically removed, she should be followed closely with no further treatment. A yearly chest x-ray would be reasonable. For metastatic disease, chemotherapy should be started. There are no trials of anti-angiogenic agents alone for adenoid cystic carcinoma.
There are few (if any) chemotherapy trials for adenoid cystic carcinoma since it is uncommon. The only anti-angiogenic option would be a phase I trial but she should not consider this unless she has failed standard therapies.
Please have your friend discuss these options with her oncologist.