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Wu X, Zhang J, Yan X, Wang Y. A rare triple-negative breast cancer: The adenoid cystic carcinoma. Asian J Surg 2024; 47:1485-1486. [PMID: 38092599 DOI: 10.1016/j.asjsur.2023.11.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/20/2023] [Accepted: 11/24/2023] [Indexed: 03/13/2024] Open
Affiliation(s)
- Xiaoyong Wu
- Hebei General Hospital (Department of Glandular Surgery), Shijiazhuang, Hebei, 050051, PR China; North China University of Science and Technology (School of Clinical Medicine), Tangshan, Hebei, 063000, PR China
| | - Jiayi Zhang
- Hebei General Hospital (Department of Glandular Surgery), Shijiazhuang, Hebei, 050051, PR China; North China University of Science and Technology (School of Clinical Medicine), Tangshan, Hebei, 063000, PR China
| | - Xuemin Yan
- Hebei General Hospital (Department of Glandular Surgery), Shijiazhuang, Hebei, 050051, PR China; North China University of Science and Technology (School of Clinical Medicine), Tangshan, Hebei, 063000, PR China
| | - Yuexin Wang
- Hebei General Hospital (Department of Glandular Surgery), Shijiazhuang, Hebei, 050051, PR China.
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Samar MR, Khan W, Mooghal M, Anjum S, Mohammad ATV, Vohra LM. Breast adenoid cystic carcinoma: An uncommon neoplasm- Case report. Int J Surg Case Rep 2023; 107:108333. [PMID: 37216733 DOI: 10.1016/j.ijscr.2023.108333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 05/24/2023] Open
Abstract
INTRODUCTION Adenoid cystic carcinoma is a neoplasm that is commonly of salivary gland origin. It could infrequently arise from other tissues such as breast in which case it behaves favorably despite belonging to triple-negative breast cancer subgroup. CASE PRESENTATION We report a case of a 49-year-old female patient, who presented with right breast pain and upon work-up, was diagnosed with early-stage adenoid cystic carcinoma of the breast. She underwent breast conservation successfully and was advised to get evaluated for adjuvant radiotherapy. The work has been reported in line with the SCARE criteria (Agha et al., 2020). CLINICAL DISCUSSION Breast adenoid cystic carcinoma (BACC) is a rare distinct salivary gland-like carcinoma of the breast with similar morphological features to those seen in salivary gland adenoid cystic carcinoma. Surgical resection is the standard mode of treatment in BACC. The role of adjuvant chemotherapy has not proven beneficial in the management of BACC, owing to the similar survival rates seen in patients with and without chemotherapy. CONCLUSION Localized breast adenoid cystic carcinoma (BACC) is an indolent disease having optimal response to surgical resection alone and thus can omit adjuvant radiotherapy and chemotherapy when completely excised. Our case is unique as BACC is a rare clinical variant of breast cancer with a very low incidence rate.
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Affiliation(s)
- Mirza Rameez Samar
- Department of Medical Oncology, Aga Khan University Hospital, Karachi, Pakistan
| | - Wajiha Khan
- Department of Medicine and Surgery, Dow University of Health Sciences, Karachi, Pakistan
| | - Mehwish Mooghal
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
| | - Saba Anjum
- Department of Histopathology, Aga Khan University Hospital, Karachi, Pakistan
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Adenoid Cystic Carcinoma of the Breast May Be Exempt from Adjuvant Chemotherapy. J Clin Med 2022; 11:jcm11154477. [PMID: 35956093 PMCID: PMC9369505 DOI: 10.3390/jcm11154477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/17/2022] [Accepted: 07/29/2022] [Indexed: 02/01/2023] Open
Abstract
Consistent standards regarding whether postoperative adjuvant chemotherapy is required in the treatment of adenoid cystic carcinoma of the breast (ACCB) are currently lacking. Using clinical data from the Surveillance, Epidemiology, and End Results (SEER) database (1988−2015), and the National Cancer Center of China (2004−2020), we retrospectively analyzed patients with ACCB who received radical treatment. A total of 661 patients were eligible. The median age at diagnosis was 61 years; 99.5% of patients were initially diagnosed with stage I and II breast cancer, and 76.7% had triple-negative breast cancer. Only 12.4% of patients received adjuvant chemotherapy. Multivariate analysis showed that patients with lymph node metastasis and non-radiotherapy had worse overall survival (OS) (p < 0.05). Patients with lymph node metastasis, stage IIB and III, histological grade ≥ 2, and non-radiotherapy had worse breast cancer-specific survival (BCSS) (p < 0.05). Adjuvant chemotherapy did not improve the OS or BCSS. Patients treated with adjuvant chemotherapy also had no better survival outcomes after propensity score matching. External data verification confirmed that chemotherapy did not improve disease-free survival or OS. Adjuvant chemotherapy cannot improve the clinical outcomes of ACCB, even in subgroups with a high risk of recurrence and metastasis.
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Liu C, Liu S, Zhao L, Zheng W, Wang K, Tian Y, Gui Z, Zhang L. Intraductal papillary carcinoma of breast with invasion: A nomogram and survival from the analysis of the SEER database. Cancer Med 2022; 12:1305-1318. [PMID: 35837839 PMCID: PMC9883418 DOI: 10.1002/cam4.5007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 05/10/2022] [Accepted: 06/24/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Intraductal papillary carcinoma (IPC) with invasion is a rare type of breast cancer. There have been few studies on its prognosis, and a nomogram that predicts the prognosis of the disease has not been described to date. METHODS Patients who were diagnosed with invasive IPC were screened from the Surveillance, Epidemiology, and End Results (SEER) database. The screened patients were randomly divided into a training cohort and a verification cohort at 7:3. A Cox proportional hazard regression model was performed to analyze the effects of different variables on the risk of death in invasive IPC. A nomogram was constructed to quantify the possibility of death. The concordance index (C-index), calibration plots, receiver operating characteristic (ROC) curves, and decision curves analysis (DCA) were used to verify the proposed model. RESULTS We included a total of 803 patients diagnosed with invasive IPC, including 563 patients in the training cohort and 240 patients in the validation cohort. The median follow-up times in the training cohort and validation cohort were 63 months (range, 2-155 months) and 61 months (range, 1-154 months), respectively. For all patients, the probability of death with invasive IPC was 1.4% within 5 years and 5.4% within 10 years. In multivariate analysis, sex, race, tumor size, lymph node status, type of treatment, and chemotherapy were related to the prognosis of invasive IPC. We constructed a nomogram to predict the possibility of death in patients with invasive IPC. CONCLUSION Patients with invasive IPC had a high survival rate. The proven nomogram was helpful to both patients and clinical decision makers.
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Affiliation(s)
- Chenguang Liu
- Department of Thyroid and Breast SurgeryTongji Hospital of Tongji Medical College of Huazhong University of Science and TechnologyWuhanChina
| | - Shiyang Liu
- Department of Thyroid and Breast SurgeryTongji Hospital of Tongji Medical College of Huazhong University of Science and TechnologyWuhanChina
| | - Lu Zhao
- Department of Thyroid and Breast SurgeryTongji Hospital of Tongji Medical College of Huazhong University of Science and TechnologyWuhanChina
| | - Weihong Zheng
- Department of Thyroid and Breast SurgeryTongji Hospital of Tongji Medical College of Huazhong University of Science and TechnologyWuhanChina
| | - Kun Wang
- Department of Thyroid and Breast SurgeryTongji Hospital of Tongji Medical College of Huazhong University of Science and TechnologyWuhanChina
| | - Yao Tian
- Department of Thyroid and Breast SurgeryTongji Hospital of Tongji Medical College of Huazhong University of Science and TechnologyWuhanChina
| | - Zhengwei Gui
- Department of Thyroid and Breast SurgeryTongji Hospital of Tongji Medical College of Huazhong University of Science and TechnologyWuhanChina
| | - Lin Zhang
- Department of Thyroid and Breast SurgeryTongji Hospital of Tongji Medical College of Huazhong University of Science and TechnologyWuhanChina
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Triple-Negative Apocrine Breast Carcinoma Has Better Prognosis despite Poor Response to Neoadjuvant Chemotherapy. J Clin Med 2022; 11:jcm11061607. [PMID: 35329934 PMCID: PMC8949126 DOI: 10.3390/jcm11061607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/25/2022] [Accepted: 03/09/2022] [Indexed: 01/13/2023] Open
Abstract
Apocrine carcinoma is a rare subtype of invasive ductal breast cancer that shows apocrine differentiation and largely triple-negative immunohistology. Triple-negative breast cancers are known to have more aggressive clinical courses. However, unlike most other subtypes, it is reported that triple-negative apocrine carcinoma (TNAC) has a better prognosis. Due to the scarcity of reported studies, our knowledge regarding its clinical behavior, prognosis and response to therapy is very limited. In this study, we retrospectively retrieved 41 triple-negative apocrine carcinoma cases from our breast cancer database, with an average follow-up of 32.8 months. It was found that TNAC had a poorer response to neoadjuvant therapy but a better prognosis than other nonapocrine types of triple-negative breast cancer. Meanwhile, TNAC has a low proliferative nature, as indicated by its low Ki-67 index. An updated analysis of the Surveillance, Epidemiology, and End Results database showed that chemotherapy did not improve breast-cancer-specific survival in TNAC patients. Our results suggest that TNAC is a special subtype of triple-negative breast cancer with a better short-term prognosis despite poor response to neoadjuvant chemotherapy.
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Li N, Feng LW, Li ZN, Wang J, Yang L. Construction and Validation of a Nomogram to Predict Overall Survival in Very Young Female Patients with Curatively Resected Breast Cancer. Cancer Manag Res 2021; 13:6181-6190. [PMID: 34393511 PMCID: PMC8354675 DOI: 10.2147/cmar.s321917] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/20/2021] [Indexed: 01/21/2023] Open
Abstract
Purpose Young age is an independent negative predictor of breast cancer (BC) survival and correlates with the risk of local recurrence and contralateral BC. We aimed to design an effective and comprehensive nomogram to predict prognosis in very young patients with curatively resected BC. Methods Female patients with a diagnosis of BC aged ≤35 years at presentation were identified from the SEER database as a training cohort. The validation cohort consisted of 1002 consecutive women with BC aged ≤35 years that had received curative resection for BC at the Sun Yat-sen University Cancer Center. A nomogram was built based on the identified variables in multivariate Cox proportional hazards model. The performance of the nomogram was quantified using Harrell’s concordance index (C-index) and calibration curves. Results Overall, 10,872 young female patients who underwent surgery for BC were enrolled in the training cohort, while 1002 very young female BC patients were identified as independent validation cohort. Eight covariables (age, race, grade; ER, PR, and HER2 status; T, and N stages) were identified and incorporated to construct a nomogram. The C-index values of the nomogram were 0.727 (95% CI: 0.714–0.740) and 0.722 (95% CI: 0.666–0.778) for OS in the training and validation cohorts, respectively. The calibration curves showed a high degree of agreement between the predicted and actual observed survival rates in both training and validation cohorts. The nomogram displayed good calibration and acceptable discrimination. Based on the TPS of the nomogram model for OS with the X-tile program, patients were divided into 3 risk groups, which were easily discriminated on survival analyses for OS. Conclusion We have successfully constructed an effective nomogram to predict survival outcomes for young female patients with curatively resected BC, which may provide individual survival prediction to benefit prognosis evaluation and individualized therapy.
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Affiliation(s)
- Ning Li
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China
| | - Li-Wen Feng
- Department of Breast Surgery, Zhongshan Torch Development Zone Hospital, Zhongshan, 528403, People's Republic of China
| | - Zuo-Nong Li
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China
| | - Jin Wang
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China
| | - Lu Yang
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China.,Department of Radiotherapy, Guangdong Provincial People's Hospital and Guangdong Academy of Medical Sciences School of Medicine, South China University of Technology, Guangzhou, 510080, People's Republic of China
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Demir S, Sezgin G, Sari AA, Kucukzeybek BB, Yigit S, Etit D, Yazici A, Kucukzeybek Y. Clinicopathological analysis of invasive cribriform carcinoma of the breast, with review of the literature. Ann Diagn Pathol 2021; 54:151794. [PMID: 34325338 DOI: 10.1016/j.anndiagpath.2021.151794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 06/27/2021] [Accepted: 07/11/2021] [Indexed: 10/20/2022]
Abstract
Invasive cribriform carcinoma (ICC) is a rare type of a primary breast carcinoma. It is subdivided into two groups as pure and mixed types. There are limited studies comparing the pure and mixed ICC at present. We aim to investigate the clinicopathological, radiological, prognostic features, and survival outcomes of two types with reviewing the published literature. 16 pure ICC and 26 mixed ICC cases were evaluated. The population consisted of 41 female and 1 male patients. The only male patient was a pure ICC case. The median age was for pure and mixed type, 46.5 and 54 years, respectively. All ICCs were ER positive. All ICCs except one mixed ICC, were positive for PR. Only one mixed ICC was accepted HER2 positive (3+). Pure ICCs showed more favorable features than mixed ICCs such as lesser axillary lymph node involvement, lower grade, and proliferation index. Twenty-five patients had one of the following imaging methods; ultrasonography (US), mammography (MG), and magnetic resonance imaging (MRI). Irregular shape, hypoechogenicity, and spiculated margins were the most common US findings. Similarly, irregular shape+spiculated margin is the most common MG findings. The median follow-up time for pure and mixed ICC was 88 and 56.5 months, respectively. One mixed ICC case developed bone metastasis. One death occurred in each group. Reasons of death were unknown. The 5-year OS for both ICC groups was 100%. 10-year OS for pure and mixed ICCs was 100% and 90%, respectively. 5-year DFS was 100% for pure ICC, and 94% for mixed ICC.
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Affiliation(s)
- Sinem Demir
- Izmir Katip Celebi University Ataturk Training and Research Hospital, Department of Pathology, Turkey
| | - Gulten Sezgin
- Izmir Katip Celebi University Ataturk Training and Research Hospital, Department of Radiology, Turkey
| | - Aysegul Akder Sari
- Izmir Katip Celebi University Ataturk Training and Research Hospital, Department of Pathology, Turkey.
| | - Betul Bolat Kucukzeybek
- Izmir Katip Celebi University Ataturk Training and Research Hospital, Department of Pathology, Turkey
| | - Seyran Yigit
- Izmir Katip Celebi University Ataturk Training and Research Hospital, Department of Pathology, Turkey
| | - Demet Etit
- Izmir Katip Celebi University Ataturk Training and Research Hospital, Department of Pathology, Turkey
| | - Ayse Yazici
- Izmir Katip Celebi University Ataturk Training and Research Hospital, Department of Pathology, Turkey
| | - Yuksel Kucukzeybek
- Izmir Katip Celebi University Ataturk Training and Research Hospital, Department of Oncology, Turkey
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