Abstract
Glycogen-rich carcinoma of the breast, an exceptionally rare subtype of invasive breast carcinoma, manifests characteristic polygonal cells with abundant clear cytoplasm containing diastase-sensitive glycogen deposits. However, varied morphologies and clinical outcomes contribute to a wide range of prognoses, warranting further investigation using updated data from the National Cancer Database to explore demographic impact on prognostic factors.
A retrospective cohort investigation of the National Cancer Database (NCDB) was conducted which spanned the years 2004-2020 involving 131 patients with a confirmed diagnosis of Glycogen-rich carcinoma. Demographic factors were examined, and a regression analysis was conducted.
Among the group of individuals diagnosed with Glycogen-rich carcinoma (GRC), the median age at diagnosis was 61 with a mean survival time post diagnosis of just under 12 years. Most (94%) underwent surgical procedures as their primary method of treatment for GRC, with the final status of surgical margins post-resection of the primary tumor revealing that the majority of cases (92%) had no residual tumor. As their primary treatment, most patients received radiation therapy (64%) and chemotherapy (62%), while a minority received hormone therapy (31%). A predominance of patients with GRC were female (97%), white (86%), and of non-Spanish, non-Hispanic origin (92%). Many cases came from a comprehensive community cancer program (44%) or an academic program (32.5%). At the time of diagnosis, the vast portion of patients (98%) were covered by some form of primary insurance with private insurance (50%) and Medicare services (41%) composing the majority of this cohort. The top primary site for nearly all cases was the breast (98%) with the upper-outer quadrant of breast (42%) and overlapping lesion of breast (20%) being the leading primary sites. Most patients (87%) were classified as either Stage I or Stage II analytic stage group. A large percentage of the individuals (86%) did not have any concurrent comorbidities (Charlson-Deyo = 0).
Following a review of the available literature, our findings suggest a possible knowledge gap in the discussion of glycogen-rich carcinoma that this novel NCDB analysis addresses. Socioeconomic factors revolving around patients living with glycogen-rich carcinoma have not yet been discussed in literature, and our findings show that a significant percentage of patients had some form of private insurance. Many were not of a minority background and a vast majority possessed few comorbidities. Given the paucity of research of this cancer, continued investigation is necessary to establish a more complete understanding of how demographics, socioeconomic factors, and treatments affect survival and outcomes of patients with glycogen-rich breast carcinoma.