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Breast Cancer of the Adenoid Cystic Carcinoma Type

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Adenoid cystic carcinoma (ACC) can occur in many parts of the body, including the breast. Dr. Bassam Ghabach of the Veterans Affairs Medical Center in Oklahoma and colleagues provided a review of breast ACC. This type has “a favorable prognosis with excellent survival,” Ghabach concluded.

Ghabach studied data from the Surveillance, Epidemiology and End Results (SEER) Program for 9 states, representing approximately 10 percent of the U.S. population, during the period 1977 to 2006. The subjects identified were 338 women and 5 men diagnosed with breast ACC. Health outcomes were analyzed for women only, since the number of men was so small.

Most of these cancers were estrogen receptor negative and progesterone receptor negative. For most types of breast cancer, these characteristics indicate a poor prognosis. Breast ACC is different. Survival rates in Ghabach's study were as follows:
1. Five-year, 98.1 percent survival.
2. Ten-year, 94.9 percent survival.
3. Fifteen-year, 91.4 percent survival.

In addition, breast ACC did not raise the risk of other cancers in this group. “Awareness of the favorable clinical behavior of breast-ACC is important, and these findings emphasize the need for clinicians to balance the risks and benefits of cytotoxic therapy given the excellent long-term survival,” Ghabach reported.

Dr. Katrina N. Glazebrook and colleagues at the Mayo Clinic, Rochester, Minnesota, provided a review of imaging results for breast ACC. This type of cancer is often detected as a mass big enough to feel by palpation, and may be painful. It is rare, accounting for approximately 0.1 percent of all breast cancers in the Mayo Clinic sample. Most cases are women in their 50's, with a smaller number of men and younger women. In Glazebrook's study, 45 percent of the patients were premenopausal.

Lumpectomy with radiation or simple mastectomy produced good results in Glazebrook's study. Additional procedures, including chemotherapy and axillary nodal sampling, were not recommended. “Recognition of ACC is important to avoid delay in diagnosis because this tumor has a good prognosis with rare metastases to axillary lymph nodes,” Glazebrook concluded.

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