Defining the clinical characteristics of mammary analog secretory carcinoma of the salivary gland: Analysis of the National Cancer Database

Akshilkumar Patel; Brandon LaBarge; Tonya S King; Sandeep Pradhan; Joshua Warrick; Neerav Goyal

doi:10.1177/20503121231200103

Defining the clinical characteristics of mammary analog secretory carcinoma of the salivary gland: Analysis of the National Cancer Database

SAGE Open Med. 2023 Sep 25:11:20503121231200103. doi: 10.1177/20503121231200103. eCollection 2023.

Authors

Akshilkumar Patel¹, Brandon LaBarge², Tonya S King³, Sandeep Pradhan³, Joshua Warrick⁴, Neerav Goyal²

Affiliations

¹ The Pennsylvania State University College of Medicine, Hershey, PA, USA.
² Department of Otolaryngology-Head and Neck Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA.
³ Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, USA.
⁴ Department of Pathology and Laboratory Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA.

Abstract

Objectives: Mammary analog secretory carcinoma (MASC) is a classification of salivary gland tumors, recently included within the term secretory carcinoma. Previous descriptions of this diagnosis have largely consisted of case reports and case series with few studies investigating its clinical characteristics as compared to non-MASC tumors. Our objective was to use a large patient database to compare the clinical characteristics of mammary analog secretory carcinoma vs. non-mammary analog secretory carcinoma salivary gland tumors.

Methods: The National Cancer Database was queried between September and October 2022 for histological diagnosis of mammary analog secretory carcinoma and non-MASC salivary tumors. Patients diagnosed with mammary analog secretory carcinoma and non-mammary analog secretory carcinoma salivary tumors between the period of 2004 through 2019 were included in this analysis. Various demographic and clinical variables were abstracted from the database and compared using Wilcoxon rank sum and chi-square tests. Survival was compared between cohorts using Cox proportional hazards regression.

Results: Overall, compared to non-mammary analog secretory carcinoma diagnoses (n = 47668), mammary analog secretory carcinoma tumors (n = 384) affected younger individuals, displayed favorable pathologic staging and tumor grade, and were less likely to invade surrounding tissues. Patients with mammary analog secretory carcinoma tumors also received treatment more quickly following diagnosis compared to patients with non-mammary analog secretory carcinoma tumors. The risk of death was 4.3 times greater for non-mammary analog secretory carcinoma diagnoses when adjusted for patient variables (hazard ratio = 4.3, 95% confidence interval [2.37-7.71], p < 0.001).

Conclusions: Clinically, mammary analog secretory carcinoma salivary tumors have a more indolent course compared to other salivary cancers. Additional studies are needed to determine the natural history of this tumor type.

Keywords: Mammary analog secretory carcinoma; head and neck neoplasms; mouth neoplasms; salivary gland neoplasms.