Department of Surgery, Abington Memorial Hospital, Abington, PA, USA.
Ann Surg Oncol. 2013 Jul;20(7):2236-41. doi: 10.1245/s10434-013-2911-z. Epub 2013 Mar 1.
Adenoid cystic carcinoma (ACC) is a rare subtype of breast malignancy.
Patients with ACC and infiltrating ductal carcinoma (IDC) reported to the National Cancer Data Base from 1998 to 2008 were reviewed for patient age, ethnicity, tumor size, nodal status, American Joint Committee on Cancer TNM Stage, tumor grade, initial treatment, hormone receptor status (for patients from 2004 to 2008), and survival (for patients from 1998 to 2003).
A total of 933 patients with ACC and 729,938 with IDC were identified. No differences were found for incidence by race/ethnicity (p = 0.97). The group with ACC was older (median 60 vs. 58 years), had larger tumors (median 18 vs. 16 mm), had more grade 1 tumors (46 vs. 18 %), was less likely to undergo axillary lymph node evaluation (75.9 vs. 96.3 %), had fewer node-positive patients (5.1 vs. 35.5 %), had fewer estrogen receptor-positive tumors (15.4 vs. 75.6 %), had fewer progesterone receptor-positive tumors (13.3 vs. 65.2 %), and underwent breast-conserving surgery more often (69.8 vs. 59.8 %). Chemotherapy was provided less often for ACC (11.3 vs. 46.4 %), as was hormone therapy (9.1 vs. 42.3 %). All of these differences were statistically significant (p < 0.0001). With a median follow-up of 65.7 months (ACC) and 64.9 months (IDC), 5-year overall survival (OS) was 88 % for ACC vs. 84 % for IDC (p = 0.02). Grade 1 OS (ACC, 91 % vs. IDC, 92 %; p = 0.50) and stage I OS (ACC, 90 % vs. IDC, 91 %; p = 0.93) were equal.
Compared with IDC, ACC has different characteristics (lower grade, hormone receptor negative, node negative), is treated differently (less axillary surgery, fewer mastectomies, less chemotherapy, less hormone therapy), and has an improved prognosis, with 88 % 5-year survival.
腺样囊性癌（ACC）是一种罕见的乳腺癌亚型。
从 1998 年至 2008 年，国家癌症数据库中报告了患有 ACC 和浸润性导管癌（IDC）的患者，回顾了患者年龄、种族、肿瘤大小、淋巴结状态、美国癌症联合委员会 TNM 分期、肿瘤分级、初始治疗、激素受体状态（2004 年至 2008 年）和生存情况（1998 年至 2003 年）。
共发现 933 例 ACC 患者和 729,938 例 IDC 患者。按种族/族裔（p=0.97）发病率无差异。ACC 组年龄较大（中位数 60 岁 vs. 58 岁），肿瘤较大（中位数 18 毫米 vs. 16 毫米），更多为 1 级肿瘤（46% vs. 18%），腋窝淋巴结评估的可能性较小（75.9% vs. 96.3%），淋巴结阳性患者较少（5.1% vs. 35.5%），雌激素受体阳性肿瘤较少（15.4% vs. 75.6%），孕激素受体阳性肿瘤较少（13.3% vs. 65.2%），保乳手术更为常见（69.8% vs. 59.8%）。ACC 患者接受化疗的比例较低（11.3% vs. 46.4%），接受激素治疗的比例也较低（9.1% vs. 42.3%）。所有这些差异均有统计学意义（p<0.0001）。中位随访 65.7 个月（ACC）和 64.9 个月（IDC），ACC 组 5 年总生存率（OS）为 88%，IDC 组为 84%（p=0.02）。1 级 OS（ACC，91% vs. IDC，92%；p=0.50）和 I 期 OS（ACC，90% vs. IDC，91%；p=0.93）相同。
与 IDC 相比，ACC 具有不同的特征（低级别、激素受体阴性、淋巴结阴性），治疗方式不同（腋窝手术较少、乳房切除术较少、化疗较少、激素治疗较少），预后较好，5 年生存率为 88%。
