title: Similar outcomes between adenoid cystic carcinoma of the breast and invasive ductal carcinoma: a population-based study from the SEER 18 database.
abstract: Adenoid cystic carcinoma of the breast (breast-ACC) is a rare and indolent tumor with a good prognosis despite its triple-negative status. However, we observed different outcomes in the present study. Utilizing the Surveillance, Epidemiology, and End Results (SEER) database, we enrolled a total of 89,937 eligible patients with an estimated 86 breast-ACC cases and 89,851 invasive ductal carcinoma (IDC) patients. In our study, breast-ACC among women presented with a higher proportion of triple-negative breast cancer (TNBC), which was more likely to feature well-differentiated tumors, rare regional lymph node involvement and greater application of breast-conserving surgery (BCS). Kaplan-Meier analysis revealed that patients with breast-ACC and breast-IDC patients had similar breast cancer-specific survival (BCSS) and overall survival (OS). Moreover, using the propensity score matching method, no significant difference in survival was observed in matched pairs of breast-ACC and breast-IDC patients. Additionally, BCSS and OS did not differ significantly between TNBC-ACC and TNBC-IDC after matching patients for age, tumor size, and nodal status. Further subgroup analysis of molecular subtype indicated improved survival in breast-ACC patients with hormone receptor-positive and human epidermal growth factor receptor 2-negative (HR+/Her2-) tumors compared to IDC patients with HR+/Her2- tumors. However, the survival of ACC-TNBC and IDC-TNBC patients was similar. In conclusion, ACCs have an indolent clinical course and result in similar outcomes compared to IDC. Understanding these clinical characteristics and outcomes will endow doctors with evidence to provide the same intensive treatment for ACC-TNBC as for IDC-TNBC and lead to more individualized and tailored therapies for breast-ACC patients.
authors.affiliation: Department of Breast Surgery, Affiliated Union Hospital, Fujian Medical University, Fuzhou, China.
authors.forename: Qing-Xia
authors.initials: QX
authors.lastname: Chen
authors.affiliation: Department of Breast Surgery, Affiliated Union Hospital, Fujian Medical University, Fuzhou, China.
authors.forename: Jun-Jing
authors.initials: JJ
authors.lastname: Li
authors.affiliation: Department of Breast Surgery, Affiliated Union Hospital, Fujian Medical University, Fuzhou, China.
authors.forename: Xiao-Xiao
authors.initials: XX
authors.lastname: Wang
authors.affiliation: Department of Breast Surgery, Affiliated Union Hospital, Fujian Medical University, Fuzhou, China.
authors.forename: Pei-Yang
authors.initials: PY
authors.lastname: Lin
authors.affiliation: Department of Breast Surgery, Affiliated Union Hospital, Fujian Medical University, Fuzhou, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Breast Surgery, Affiliated Union Hospital, Fujian Medical University, Fuzhou, China.
authors.forename: Chuan-Gui
authors.initials: CG
authors.lastname: Song
authors.affiliation: Department of Breast Surgery, Key Laboratory of Breast Cancer, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Zhi-Ming
authors.initials: ZM
authors.lastname: Shao
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D003528:Carcinoma, Adenoid Cystic / Q000737:chemistry / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D018270:Carcinoma, Ductal, Breast / Q000737:chemistry / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D002454:Cell Differentiation; D016009:Chi-Square Distribution; D016208:Databases, Factual; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D057216:Propensity Score; D016016:Proportional Hazards Models; D012307:Risk Factors; D018426:SEER Program; D013997:Time Factors; D016896:Treatment Outcome; D064726:Triple Negative Breast Neoplasms / Q000737:chemistry / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor
keywords: adenoid cystic carcinoma; breast cancer-specific survival; invasive ductal carcinoma; overall survival