title: First description of an acinic cell carcinoma of the breast in a BRCA1 mutation carrier: a case report.
abstract: BACKGROUND
  Acinic cell carcinoma (ACC) is a rare malignant epithelial neoplasm characterized by the presence of malignant tubular acinar exocrine gland structures. Diagnosis is generally made in salivary glands and in the pancreas. ACC of the breast has been reported in few cases only. Carriers of inherited mutations in the BRCA1 gene are prone to the development of breast cancer, mainly invasive ductal or medullary type carcinomas. We describe for the first time a BRCA1 mutation carrier with a diagnosis of ACC of the breast.
  
  
  METHODS
  The patient developed an invasive ductal carcinoma (IDC) at the age of 40 years and an ACC in the contralateral breast at 44 years. Immunohistochemical examination of the ACC revealed a triple negative status (i.e., negativity for estrogen receptor, progesterone receptor and HER2 protein) and positivity for p53. Using a combination of loss of heterozygosity (LOH) and sequencing analyses, the loss of the wild-type BRCA1 allele was detected in both the ACC and the IDC. In addition, two different somatic TP53 mutations, one in the ACC only and another one in the IDC only, were observed.
  
  
  CONCLUSIONS
  Both the immunohistochemical and molecular features observed in the ACC are typical of BRCA1-associated breast cancers and suggest an involvement of the patient's germline mutation in the disease. The occurrence of rare histological types of breast cancers, including malignant phyllodes tumor, atypical medullary carcinoma and metaplastic carcinoma, in BRCA1 mutation carriers has been already reported. Our findings further broaden the spectrum of BRCA1-associated breast malignancies.
authors: Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors: Carla B
authors: CB
authors: Ripamonti
authors: Mara
authors: M
authors: Colombo
authors: Patrizia
authors: P
authors: Mondini
authors: Manoukian
authors: M
authors: Siranoush
authors: Bernard
authors: B
authors: Peissel
authors: Loris
authors: L
authors: Bernard
authors: Paolo
authors: P
authors: Radice
authors: Maria Luisa
authors: ML
authors: Carcangiu
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000235:genetics* / Q000378:metabolism / Q000601:surgery; D018267:Carcinoma, Acinar Cell / Q000235:genetics* / Q000378:metabolism / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000235:genetics* / Q000601:surgery; D005260:Female; D019398:Genes, BRCA1; D006579:Heterozygote; D006801:Humans; D009154:Mutation; D016609:Neoplasms, Second Primary / Q000235:genetics* / Q000601:surgery; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D016159:Tumor Suppressor Protein p53 / Q000235:genetics
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D016159:Tumor Suppressor Protein p53; C508053:ERBB2 protein, human
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