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Purpose <p>Acinic cell carcinoma (ACC) of the breast is a rare malignancy characterized by serous acinar differentiation resembling salivary gland ACC. Although historically described as a triple-negative malignancy, its immunophenotypic profile and clinical behavior remain incompletely characterized. This study leverages a large national database to characterize the clinicopathologic features, treatment approaches, and survival outcomes of breast ACC.</p> Methods <p>The National Cancer Database (NCDB) was queried for patients with invasive breast ACC diagnosed between 2004 and 2023. Overall survival (OS) was assessed using Kaplan-Meier analysis and compared with log-rank tests. Multivariable Cox regression analysis was used to evaluate independent associations with OS.</p> Results <p>A total of 149 patients with breast ACC were identified. Mean age was 57.8 ± 14.3 years, and median tumor size was 2.0&#xa0;cm. Most patients presented with early-stage disease (Stage I–II, 86.7%). 44.6% demonstrated poorly differentiated or anaplastic tumors. Node-positive disease was present in 27.0% of patients. Hormone receptor expression was common (ER 57.1%, PR 50.7%), while 93.5% were HER2-negative. The 5-year OS was 82.9%. Older age (<i>p</i> &lt; 0.001), advanced stage (<i>p</i> &lt; 0.001), and nodal positivity (<i>p</i> = 0.038) were associated with worse OS. Surgical resection was associated with improved survival (<i>p</i> &lt; 0.001), while radiation, chemotherapy and hormonal therapy were not associated with OS. On multivariable analysis, surgical resection remained independently associated with survival (HR 0.03, 95% CI 0.005–0.25, <i>p</i> &lt; 0.001).</p> Conclusions <p>Breast ACC presents at an early stage with hormone receptor heterogeneity. Surgical resection was the only modality independently associated with improved survival.</p>

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Clinicopathologic features, treatment patterns and survival outcomes of acinic cell carcinoma of the breast: a national cancer database analysis

  • 期刊论文

  • 发表日期：

    2026年7月14日

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  • Cher Ying Foo,
  • Ojasav Sehrawat,
  • Akshjot Puri,
  • Waqar Haque,
  • Bin S. Teh

摘要

Purpose

Acinic cell carcinoma (ACC) of the breast is a rare malignancy characterized by serous acinar differentiation resembling salivary gland ACC. Although historically described as a triple-negative malignancy, its immunophenotypic profile and clinical behavior remain incompletely characterized. This study leverages a large national database to characterize the clinicopathologic features, treatment approaches, and survival outcomes of breast ACC.

Methods

The National Cancer Database (NCDB) was queried for patients with invasive breast ACC diagnosed between 2004 and 2023. Overall survival (OS) was assessed using Kaplan-Meier analysis and compared with log-rank tests. Multivariable Cox regression analysis was used to evaluate independent associations with OS.

Results

A total of 149 patients with breast ACC were identified. Mean age was 57.8 ± 14.3 years, and median tumor size was 2.0 cm. Most patients presented with early-stage disease (Stage I–II, 86.7%). 44.6% demonstrated poorly differentiated or anaplastic tumors. Node-positive disease was present in 27.0% of patients. Hormone receptor expression was common (ER 57.1%, PR 50.7%), while 93.5% were HER2-negative. The 5-year OS was 82.9%. Older age (p < 0.001), advanced stage (p < 0.001), and nodal positivity (p = 0.038) were associated with worse OS. Surgical resection was associated with improved survival (p < 0.001), while radiation, chemotherapy and hormonal therapy were not associated with OS. On multivariable analysis, surgical resection remained independently associated with survival (HR 0.03, 95% CI 0.005–0.25, p < 0.001).

Conclusions

Breast ACC presents at an early stage with hormone receptor heterogeneity. Surgical resection was the only modality independently associated with improved survival.