| Primary acinic cell carcinoma (ACC) of the breast is an extremely rare subtype of triple-negative breast cancer, characterized histologically by serous acinar differentiation and cytoplasmic zymogen granules. Although ACC of the breast typically exhibits indolent biological behavior, approximately 25% of patients may experience recurrence, metastasis, or death. This article reports a case of primary ACC of the breast in a 46-year-old female and analyzes its clinical, imaging, and pathological features to enhance the understanding of breast ACC. |