Management of Adenoid Cystic Carcinoma of the Breast: A Rare Cancer Network Study

Journal Article · Sun Apr 01 04:00:00 EDT 2012 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2010.12.008· OSTI ID:22056285

Khanfir, Kaouthar ^[1]; Kallel, Adel ^[2]; Villette, Sylviane ^[3]; Belkacemi, Yazid ^[4]; Vautravers, Claire ^[5]; Nguyen, TanDat ^[6]; Miller, Robert ^[7]; Yexiong, Li ^[8]; Taghian, Alphonse G ^[9]; Boersma, Liesbeth ^[10]; Poortmans, Philip ^[11]; Goldberg, Hadassah ^[12]; Vees, Hansjorg ^[13]; Senkus, Elzbieta ^[14]; Igdem, Sefik; Ozsahin, Mahmut ^[15]; Jeanneret Sozzi, Wendy ^[16]

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1. Hopital de Sion, CHCVs, Sion (Switzerland)
2. Institut Gustave Roussy, Villejuif (France)
3. Centre Rene Huguenin, Paris (France)
4. CHU Henri Mondor, Centre Oscar Lambret, Lille (France)
5. Centre George Francois Leclerc, Dijon (France)
6. Institut Jean Gaudinot, Reims (France)
7. Mayo Clinic, Rochester, Minnesota (United States)
8. Peking Union Medical College, Beijing (China)
9. Massachusetts General Hospital, Boston, Massachusetts (United States)
10. Maastricht University Medical Center (MAASTRO clinic), Maastricht (Netherlands)
11. Dr. Bernard Verbeeten Institute, Tilburg (Netherlands)
12. Western Galilee Hospital-Nahariya, Nahariya (Israel)
13. Hopitaux Universitaires de Geneve, Geneva (Switzerland)
14. Medical University of Gdansk, Gdansk (Poland)
15. Istanbul Bilim University, Istanbul (Turkey)
16. Centre Hospitalier Universitaire Vaudois, Lausanne (Switzerland)

Background: Mammary adenoid cystic carcinoma (ACC) is a rare breast cancer. The aim of this retrospective study was to assess prognostic factors and patterns of failure, as well as the role of radiation therapy (RT), in ACC. Methods: Between January 1980 and December 2007, 61 women with breast ACC were treated at participating centers of the Rare Cancer Network. Surgery consisted of lumpectomy in 41 patients and mastectomy in 20 patients. There were 51(84%) stage pN0 and 10 stage cN0 (16%) patients. Postoperative RT was administered to 40 patients (35 after lumpectomy, 5 after mastectomy). Results: With a median follow-up of 79 months (range, 6-285), 5-year overall and disease-free survival rates were 94% (95% confidence interval [CI], 88%-100%) and 82% (95% CI, 71%-93%), respectively. The 5-year locoregional control (LRC) rate was 95% (95% CI, 89%-100%). Axillary lymph node dissection or sentinel node biopsy was performed in 84% of cases. All patients had stage pN0 disease. In univariate analysis, survival was not influenced by the type of surgery or the use of postoperative RT. The 5-year LRC rate was 100% in the mastectomy group versus 93% (95% CI, 83%-100%) in the breast-conserving surgery group, respectively (p = 0.16). For the breast-conserving surgery group, the use of RT significantly correlated with LRC (p = 0.03); the 5-year LRC rates were 95% (95% CI, 86%-100%) for the RT group versus 83% (95% CI, 54%-100%) for the group receiving no RT. No local failures occurred in patients with positive margins, all of whom received postoperative RT. Conclusion: Breast-conserving surgery is the treatment of choice for patients with ACC breast cancer. Axillary lymph node dissection or sentinel node biopsy might not be recommended. Postoperative RT should be proposed in the case of breast-conserving surgery.

• OSTI ID: 22056285
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 5 Vol. 82; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BIOPSY
CARCINOMAS
FAILURES
LYMPH NODES
MAMMARY GLANDS
PATIENTS
RADIOTHERAPY
SURGERY
WOMEN