Abstract
Salivary and mammary gland tumors show morphological similarities and share various characteristics, including frequent overexpression of hormone receptors and female preponderance. Although this may suggest a common etiology, it remains unclear whether patients with a salivary gland tumor carry an increased risk of breast cancer (BC). Our purpose was to determine the risk of BC in women diagnosed with salivary gland carcinoma (SGC) or pleomorphic adenoma (SGPA). BC incidence (invasive and in situ) was assessed in two nationwide cohorts: one comprising 1567 women diagnosed with SGC and one with 2083 women with SGPA. BC incidence was compared with general population rates using standardized incidence ratio (SIR). BC risk was assessed according to age at SGC/SGPA diagnosis, follow‐up time and (for SGC patients) histological subtype. The mean follow‐up was 7.0 years after SGC and 9.9 after SGPA diagnosis. During follow‐up, 52 patients with SGC and 74 patients with SGPA developed BC. The median time to BC was 6 years after SGC and 7 after SGPA. The cumulative risk at 10 years of follow‐up was 3.1% after SGC and 3.5% after SGPA (95% Confidence Interval (95%CI) 2.1%–4.7% and 2.6%–4.6%, respectively). BC incidence was 1.59 times (95%CI 1.19–2.09) higher in the SGC‐cohort than expected based on incidence rates in the general population. SGPA‐patients showed a 1.48 times (95%CI 1.16–1.86) higher incidence. Women with SGC or SGPA have a slightly increased risk of BC. The magnitude of risk justifies raising awareness, but is no reason for BC screening.
Highlights
Benign salivary gland tumors occur 6–7 times more frequently than malignant tumors and the salivary gland pleomorphic adenoma (SGPA), which accounts for two thirds of all benign salivary gland tumors, may occasionally show malignant transformation.[2,3,4,5,6]
A sensitivity analysis, showed similar risks after exclusion of synchronous breast cancer (BC) (n = 4), defined as all BC diagnosed
In this large and nationwide study with long-term complete follow-up, including 3650 women diagnosed with SGC and SGPA, the risk of developing a subsequent BC is moderately increased
Summary
Whereas the larger amount of glandular breast tissue (next to hormonal, lifestyle, and genetic factors) puts women at higher risk of BC than men, gland volume does not explain the higher risk of a salivary gland tumor in women, since there are no gender differences in salivary gland size.[17] Differential attitudes toward physical appearance or towards medical attention seeking behavior between males and females are unlikely to play a major role in explaining gender variation in incidence of SGC and SGPA, due to visibility of the tumor.[18,19,20]
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