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. 2022 Mar 14;11(6):1607.
doi: 10.3390/jcm11061607.

Triple-Negative Apocrine Breast Carcinoma Has Better Prognosis despite Poor Response to Neoadjuvant Chemotherapy

Taobo Hu  1 , Yiqiang Liu  2 , Jinbo Wu  1 , Xuejiao Lina Hu  3 , Guiyang Zhao  4 , Baosheng Liang  5 , Shu Wang  1 , Mengping Long  2
Affiliations

Triple-Negative Apocrine Breast Carcinoma Has Better Prognosis despite Poor Response to Neoadjuvant Chemotherapy

Taobo Hu et al. J Clin Med. .

Abstract

Apocrine carcinoma is a rare subtype of invasive ductal breast cancer that shows apocrine differentiation and largely triple-negative immunohistology. Triple-negative breast cancers are known to have more aggressive clinical courses. However, unlike most other subtypes, it is reported that triple-negative apocrine carcinoma (TNAC) has a better prognosis. Due to the scarcity of reported studies, our knowledge regarding its clinical behavior, prognosis and response to therapy is very limited. In this study, we retrospectively retrieved 41 triple-negative apocrine carcinoma cases from our breast cancer database, with an average follow-up of 32.8 months. It was found that TNAC had a poorer response to neoadjuvant therapy but a better prognosis than other nonapocrine types of triple-negative breast cancer. Meanwhile, TNAC has a low proliferative nature, as indicated by its low Ki-67 index. An updated analysis of the Surveillance, Epidemiology, and End Results database showed that chemotherapy did not improve breast-cancer-specific survival in TNAC patients. Our results suggest that TNAC is a special subtype of triple-negative breast cancer with a better short-term prognosis despite poor response to neoadjuvant chemotherapy.

Keywords: androgen receptor; invasive apocrine carcinoma; neoadjuvant therapy; triple-negative breast cancer.

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Conflict of interest statement

The authors declare no competing interest.

Figures

Figure 1
Figure 1
Representative HE and IHC staining images from TNAC and TNBC-NA patients. Scale bar indicates 50 μm.
Figure 2
Figure 2
Survival plot for TNAC and TNBC-NA cohort. (A) Overall survival (OS), (B) distant metastasis-free survival (DMSF) and (C) disease-free survival (DFS) of TNAC and TNBC-NA groups were analyzed with Kaplan–Meier curve.
Figure 3
Figure 3
Paired Miller–Payne grading (A) and Residual Cancer Burden grading (B) of the study cohort. TNAC cases are plotted with red dots and TNBC-NA cases are plotted with green triangles. Each TNAC and TNBC-NA pair is connected with a black line. MP grade system is based on a 5-point scale system with point 5 indicating complete response and point 1 indicating no response. RCB index divided the residual disease into four categories: RCB-0 (pCR), RCB-I (minimal residual disease), RCB-II (moderate residual disease) and RCB-III (extensive residual disease). Statistical analysis was performed with a one-sided paired Wilcoxon test.
Figure 4
Figure 4
Survival plots of chemotherapy group and no-chemotherapy group of TNAC patients from SEER. Breast-cancer-specific survival (BCSS) and overall survival (OS) of TNAC patients before matching (A,B) and after matching (C,D) were analyzed with Kaplan–Meier curves. Numbers at risk are displayed below.
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