Predictors of Outcome in Mammary Adenoid Cystic Carcinoma

作者：Elzbieta A. Slodkowska, Bin Xu, Zuzana Kos, Anita L. Bane, Maja Barnard, Judit T. Zubovits, Pratibha Iyengar, Hala Faragalla, Dmitry A. Turbin, Phillip A. Williams, Penny J. Barnes, Anna Marie Mulligan · 发表于：The American Journal of Surgical Pathology · 年份：2019 · DOI：10.1097/pas.0000000000001378 · 被引用次数：45 · 研究领域：Salivary Gland Tumors Diagnosis and Treatment、Ear and Head Tumors、Head and Neck Anomalies

Mammary adenoid cystic carcinoma (ACC) is a rare subtype of breast cancer with a favorable prognosis. Here we report on predictors of outcome based on a detailed morphologic review and analysis of 108 mammary ACC. Sixty-four tumors (59.2%) were pure conventional ACC, 23 (21.3%) were pure basaloid ACC. Follow-up was available for 87 patients (median: 51 mo). Eighteen patients (20.7%) developed recurrence: 7 (8%) had local recurrence and 14 (16%) had distant metastasis. Two patients died of disease, 1 died of an unrelated cause, 14 were alive with disease (including 8 in palliative care), and 70 (80.5%) were alive with no evidence of disease. Of 90 patients with known lymph node (LN) status 9 (10%) had nodal involvement (all with basaloid ACC). Distant metastases in patients with predominantly basaloid ACC compared with pure conventional ACC were more common (40% vs. 7.7%) and occurred earlier (22 vs. 84 mo). The following factors were found to be predictive of recurrence-free survival: positive margin, Nottingham grade, neovascularization, basaloid component, perineural invasion, lymphovascular invasion, >30% solid growth, necrosis and LN involvement; the first 3 remained statistically significant on multivariate analysis. Factors predictive of distant disease-free survival were neovascularization, Nottingham grade, lymphovascular invasion, solid component >50%, LN involvement, basaloid component >50%, tumor necrosis, perineural invasion, and final margin. Only neovascularizat...