Triple‐negative apocrine carcinoma: A rare pathologic subtype with a better prognosis than other triple‐negative breast cancers

Abstract

Background and Methods: Apocrine adenocarcinoma is a rare subtype of breast cancer. We sought to compare the characteristics and survival of patients diagnosed with triple-negative apocrine adenocarcinoma to those of patients diagnosed with triple-negative invasive ductal carcinoma. Utilizing data from the National Cancer Database between 2004 and 2013, 70 524 eligible female patients with triplenegative breast cancer were identified including 566 patients with apocrine adenocarcinomas and 69 958 patients with invasive ductal carcinoma. Descriptive statistics for each variable were reported. A comparison of each covariate between the study cohorts was assessed in univariate and multivariate analysis. Cox proportional models were used to calculate hazard ratios. Additionally, the propensity score matching method was implemented to reduce treatment selection bias. Results: Patients with triple-negative apocrine tumors were more likely to be older, Caucasian, and have smaller, moderately to well-differentiated tumors. Multivariable analysis noted a significantly improved survival for patients with triple-negative apocrine carcinoma (TNAC) vs triple-negative invasive ductal carcinoma (TNBC) (hazard ratio [HR] 0.65 [95% confidence interval [CI] [0.53-0.81], P = 0 < .001). Propensity score matching analysis confirmed a significant difference in overall survival for patients with TNAC in comparison to TNBC (HR 0.79 [95% CI [0.63-1.00], P = .05). Discussion: Triple-negative apocrine adenocarcinomas have a modestly improved long-term survival when compared with triple-negative invasive ductal cancers.

HER2-positive Apocrine Carcinoma of the Breast: A population-based Analysis of Treatment and Outcome

“…Our results are in line with a recently published SEER cohort of triple-negative APO carcinomas, which also revealed that these cancers had a better prognosis than TNBC NST [23]. Several other independent studies con rmed a more favorable outcome for triple-negative APO patients [1,17]. In contrast, the studies of Dellapasqua et al [4] and Bonnefoi et al [2] reported a poor outcome of molecular apocrine tumors/pure apocrine carcinomas (as de ned by gene expression analysis and/or immunohistochemistry) from the cohorts of the European Institute of Oncology and the EORTC 10994/BIG 1-00 phase III study, respectively.…”

Triple-negative apocrine carcinoma as a rare cause of a breast lump in a Syrian female: a case report and review of the literature

“…In a large cohort study by Arciero et al, triple-negative apocrine carcinomas TNACs had a significantly better overall survival compared to triple-negative invasive ductal carcinomas TNBCs. Also, their study demonstrated that most TNAC cases were associated with older age, lower T stage, and tumor grade [ 4 ]. Similar results were demonstrated by Wu et al in a large SEER-based study, and in a small limited case–control study by Meattini et al Studies referred this difference to the overexpression of AR and GCDFP-15 which might be associated with a decreased tumor proliferation and subsequently, a better prognosis [ 18 , 19 ].…”

“…Human epidermal growth factor receptor-2 (HER2/neu) overexpression is present in approximately 50% of apocrine carcinoma cases [ 2 ], whereas HER2-negative apocrine carcinomas are classified as triple-negative apocrine carcinomas (TNACs) which are extremely rare neoplasms constituting less than 1% of all triple-negative breast cancers (TNBCs) [ 3 ]. Although TNBCs have a poor prognosis due to the negative expression of hormone receptors and the inability to apply targeted therapy, triple-negative apocrine carcinomas were found to have a better prognosis and overall survival, which highlights the importance of diagnosing and distinguishing this rare subtype [ 4 ]. Herein, we present the first case report from Syria of a 45-year-old female who was diagnosed with a triple-negative apocrine carcinoma.…”

Triple negative apocrine breast carcinoma has better prognosis despite poor response to neoadjuvant chemotherapy

“…The analysis of both SEER database and National Cancer Database (NCD) showed that TNAC has a better prognosis than TNBC [13,14]. Study comparing TNAC that did not receive adjuvant chemotherapy with matched triple negative invasive ductal carcinoma that received adjuvant chemotherapy showed that the two groups share similar prognosis which indicate a potential de-escalation in the management of TNAC [15].…”