Adenoid cystic carcinoma, predominantly a tumour of salivary gland, very rarely affects the breast. Very few cases have been reported in literature and there is no optimal consensus on management. In this narrative review, we report a case of adenoid cystic carcinoma breast treated with surgery followed by adjuvant chemotherapy and radiation therapy. It is an indolent tumour with very low predilection for lymphatic dissemination. A balanced translocation in MYB-NFIB fusion gene appears to be fundamental in the pathogenesis. Surgery forms the mainstay treatment option followed by adjuvant radiation in high risk cases, as extrapolated from studies in salivary gland tumour.