Lee Sang Min, Jang Bum-Sup, Park Won, Kim Yong Bae, Song Jin Ho, Kim Jin Hee, Kim Tae Hyun, Kim In Ah, Lee Jong Hoon, Ahn Sung-Ja, Kim Kyubo, Chang Ah Ram, Kwon Jeanny, Park Hae Jin, Shin Kyung Hwan
Department of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Cancer Res Treat. 2025 Jan;57(1):150-158. doi: 10.4143/crt.2024.201. Epub 2024 Jul 12.
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.
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.
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.
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.
本研究旨在评估乳腺腺样囊性癌（ACC）的治疗方法和局部区域模式，该肿瘤为罕见恶性肿瘤，临床数据有限。
从多机构收集了1992年至2022年间诊断为原发性乳腺ACC的93例患者。所有患者均接受了手术切除，包括保乳手术（BCS）或全乳切除术（TM）。评估复发模式和局部区域无复发生存期（LRFS）。
75例患者（80.7%）接受了BCS，其中71例（94.7%）接受了术后放疗（PORT）。18例患者（19.3%）接受了TM，其中5例（27.8%）也接受了PORT。中位随访50个月，5年时LRFS率为84.2%。5例患者（5.4%）出现局部复发（LR），其中4例（80%）发生在瘤床。75例BCS患者中有3例（3/75，4.0%）有BCS和PORT史，18例接受乳房切除术的患者中有2例（2/18，11.1%）有局部复发史。2例患者（2.2%）出现区域复发，2例均有PORT史，其中1例（n = 1）区域淋巴结接受了放疗，1例（n = 1）未接受区域淋巴结放疗。部分乳腺照射（p = 0.35）、BCS（p = 0.96）以及BCS组的PORT（p = 0.33）与LRFS无显著相关性。
BCS联合PORT是乳腺ACC的主要治疗方法，LR大多发生在瘤床。本研究结果表明，原发性乳腺ACC的PORT可考虑采用部分乳腺照射。
