Adenoid Cystic Breast Cancer Spreads to the Kidney, Lungs, Bone and Spleen

What happened, in summary

A 70-year-old woman presented with an ulcerated mass in her left breast and was diagnosed with a rare adenoid cystic carcinoma with a triple-negative profile. She underwent radical mastectomy with sentinel lymph-node biopsy in December 2017, followed by breast radiation in February 2018.

Two years later, imaging for pain found a large mass in the left kidney. She underwent radical nephrectomy in December 2019, and pathology showed that the kidney tumor matched the breast cancer, confirming metastatic spread. Subsequent scans showed growing lung nodules and later more extensive disease involving abdominal and chest lymph nodes, the spleen, the right kidney, and the C4 vertebra.

She received palliative radiation to the C4 lesion and began doxorubicin plus cyclophosphamide in December 2021. Treatment was stopped after 2 administrations because of toxicity, worsening condition, and further progression. Additional palliative radiation was given to the retroperitoneal area for pain. By spring 2022, she had progressive cachexia, abdominal pain, and further metastatic disease on imaging. In May 2022, the care plan shifted to best supportive care.