687P Recurrence risk and overall survival in stage II ER+/HER2- early breast cancer patients: A population-based registry study in Sweden

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Background: Glycogen-rich clear cell carcinoma (GRCC) of the breast is rare subtype of invasive breast carcinoma, characterized by neoplastic cells with a glycogenabundant clear cytoplasm.Due to the rarity of this disease, existing literature is limited to case reports and limited case series with conflicting data. Methods:The National Cancer Database (NCDB) was queried for patients with invasive GRCC of the breast between 2004 to 2023.Baseline demographic, tumor, and treatment characteristics were summarized descriptively.Overall survival (OS) was assessed using Kaplan-Meier analysis and compared using log-rank tests.Multivariable Cox proportional hazards regression was performed to evaluate independent associations with OS.Results: A total of 132 patients with GRCC were identified.Median age at diagnosis was 61 years (IQR 50-71), and the median tumor size was 2.0 cm (IQR 1.4-3.0).Median follow-up was 85.0 months (IQR 48.9-137.9),during which 42 (31.8%)deaths occurred.Most patients presented with early-stage disease (48.8% Stage I, 41.0% Stage II), and 28.3% had node-positive disease.Surgical resection was performed in 90.9% of patients, and the most common surgical procedure was lumpectomy (40.9%).Chemotherapy, hormonal, and radiation therapy were administered in 63.6%, 56.8% and 56.1% of patients respectively.Tumors were predominantly estrogen receptor-positive (75.0%) and HER2-negative (92.9%).Surgical management (p<0.0001)and chemotherapy (p=0.004) were significantly associated with improved OS, whereas immunotherapy, hormone therapy, radiation therapy were not associated with OS.On multivariable analysis, advanced age (HR 1.04, 95% CI 1.01-1.08,p=0.020) and tumor size (HR 1.02, 95% CI 1.01-1.04,p=0.011) were significantly associated with worse OS.Surgical management remained independently associated with OS (HR 0.31, 95% CI 0.11-0.87,p=0.026), whereas chemotherapy was not associated with OS. Conclusions:In this largest study of GRCC to date, we found that GRCC has a higher incidence in post-menopausal women, often presenting as a small primary tumor albeit with a higher likelihood of lymph node positivity and higher mortality rate when compared to IDC.

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