Adenoid Cystic Breast Carcinoma: Is Axillary Staging Necessary in All Cases? Results from the California Cancer Registry

Abstract

Introduction Adenoid cystic carcinoma is an uncommon type of breast cancer. There are limited data about its epidemiology, tumor characteristics, and outcomes. Using a large, population-based database, this study aims to identify specific characteristics of patients with adenoid cystic breast cancer, investigate its natural history, and determine its long-term prognosis. Methods The California Cancer Registry (CCR), a population-based registry, was reviewed from the years 1988 to 2006. The data were analyzed with relation to patient age, tumor size and stage, and overall survival. Relative cumulative actuarial survival was determined using the Berkson-Gage life table method. Results A total of 244 cases of invasive adenoid cystic cancer were identified in women during this time period. The patients’ median age was 61.9 years. Most cases were diagnosed in non-Hispanic White women (82%, n=200), followed by African-American (6%, n=15), Asian/Pacific-Islander (5.7%, n=14) and Hispanic women (4.4%, n=12). The remainder of the patients was of unknown or other ethnicity. Tumors were between 1 and 140 mm in size. At the time of diagnosis, 92% (n=225) of patients had localized disease, 5% (n=12) of patients had regional disease, and even fewer (n=7) had either distant or unknown staged disease. Lymph node involvement was not present in any tumors smaller than 1.4 cm. The relative cumulative survival of patients with adenoid cystic breast carcinoma was 95.6% at 5 years and 94.9% at 10 years. Conclusion Adenoid cystic carcinoma of the breast is a rare disease with an overall good prognosis. Knowing that this cancer usually presents as localized disease, with lymph node involvement seen only with larger tumors, can help clinicians plan the operative management of these tumors.

Is axillary surgery beneficial for patients with adenoid cystic carcinoma of the breast?

“…Due to its rarity, there is a lack of consensus on optimal surgical management. Current data are limited to small case series and only a few large database studies, which demonstrate very low rates of nodal involvement …”

Adenoid Cystic Carcinoma of The breast: a Clinical Case Report

“…As shown Table 2, after definitive treatment, the 10-year overall survival rate is 86% to 95%, and lymph node metastasis is very rare, as well as distant metastases (3, 7-10). Data from the published literature indicate that ACCs of the breast have a very good prognosis after achieving local control, and the overall survival is not significantly different from the general population.…”

Adenoid cystic carcinoma of the breast: A case report and literature review

“…However, perineural invasion is extremely rare in ACCs of the breast (14). In the present case, perineural invasion was present.…”