Cancer Res Treat.  2025 Jan;57(1):150-158. 10.4143/crt.2024.201.

Locoregional Recurrence in Adenoid Cystic Carcinoma of the Breast: A Retrospective, Multicenter Study (KROG 22-14)

• Lee SM
• Jang BS
• Park W
• Kim YB
• Song JH
• Kim JH
• Kim TH
• Kim IA
• Lee JH
• Ahn SJ
• Kim K
• Chang AR
• Kwon J
• Park HJ
• Shin KH

• KMID: 2564589
• DOI: http://doi.org/10.4143/crt.2024.201

Abstract

Purpose
This study aims to evaluate the treatment approaches and locoregional patterns for adenoid cystic carcinoma (ACC) in the breast, which is an uncommon malignant tumor with limited clinical data.
Materials and Methods
A total of 93 patients diagnosed with primary ACC in the breast between 1992 and 2022 were collected from multi-institutions. All patients underwent surgical resection, including breast-conserving surgery (BCS) or total mastectomy (TM). Recurrence patterns and locoregional recurrence-free survival (LRFS) were assessed.
Results
Seventy-five patients (80.7%) underwent BCS, and 71 of them (94.7%) received post-operative radiation therapy (PORT). Eighteen patients (19.3%) underwent TM, with five of them (27.8%) also receiving PORT. With a median follow-up of 50 months, the LRFS rate was 84.2% at 5 years. Local recurrence (LR) was observed in five patients (5.4%) and four cases (80%) of the LR occurred in the tumor bed. Three of LR (3/75, 4.0%) had a history of BCS and PORT, meanwhile, two of LR (2/18, 11.1%) had a history of mastectomy. Regional recurrence occurred in two patients (2.2%), and both cases had a history of PORT with (n=1) and without (n=1) irradiation of the regional lymph nodes. Partial breast irradiation (p=0.35), BCS (p=0.96) and PORT in BCS group (p=0.33) had no significant association with LRFS.
Conclusion
BCS followed by PORT was the predominant treatment approach for ACC of the breast and LR mostly occurred in the tumor bed. The findings of this study suggest that partial breast irradiation might be considered for PORT in primary breast ACC.

Keyword

Adenoid cystic carcinoma; Breast neoplasms; Segmental mastectomy; Mastectomy; Radiotherapy; Recurrence pattern

Figure

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  Fig. 1. Pattern of recurrence. DM, distant metastasis; LR, local recurrence; RR, regional recurrence.

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  Fig. 2. Local recurrence pattern by treatment. ACC, adenoid cystic carcinoma; BCS, breast-conserving surgery; PBI, partial breast irradiation; PORT, post-operative radiation therapy; TM, total mastectomy; WBI, whole breast or chest wall irradiation.

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  Fig. 3. Kaplan-Meier graphs for locoregional recurrence-free survival and progression-free survival in adenoid cystic carcinoma of the breast. (A) Locoregional recurrence-free survival. (B) Progression-free survival.

Reference

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