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. 2022 Jun;193(2):523-533.
doi: 10.1007/s10549-022-06578-4. Epub 2022 Mar 30.

HER2-positive apocrine carcinoma of the breast: a population-based analysis of treatment and outcome

Faruk Skenderi #  1 , Mohamad Alhoda Mohamad Alahmad #  2 , Emin Tahirovic #  3 , Yaman M Alahmad  4   5 , Zoran Gatalica  6 , Semir Vranic  7
Affiliations

HER2-positive apocrine carcinoma of the breast: a population-based analysis of treatment and outcome

Faruk Skenderi et al. Breast Cancer Res Treat. 2022 Jun.

Abstract

Purpose: Apocrine carcinoma of the breast (APO) expresses HER2 in 30-50% of cases. This study explored the clinicopathological features and outcome of HER2+/APO and matched HER2+/NST cohort.

Methods: We used the SEER database to explore the cohorts. Univariate and multivariate analyses were used to assess the survival. Based on ER and PR [steroid receptors/SR/] and HER2 status, we divided the cohorts to match the intrinsic molecular subtypes for comparisons.

Results: We retrieved 259 cases of HER2+/APO. Most HER2+/APO were SR negative (65%). HER2+/APO were more prevalent in the 80+ age group (24.7% vs. 15.7%, p < 0.001). HER2+/SR-/APO had a significantly lower histological grade than the HER2+/SR-/NST (p < 0.001). Breast cancer-related deaths were more prevalent in HER2+/NST (7.8% vs. 3.9%, p = 0.019). This was particularly evident between SR- subgroups (10.4% in HER2+/SR-/NST vs. 4.2% in HER2+/SR-/APO, p = 0.008) and was reaffirmed in breast cancer-specific survival in univariate analysis (p = 0.03). Other than race and SR status, HER2+/APO subgroups did not differ in clinicopathological parameters.

Conclusions: Our study confirms the rarity of the APO and reveals that SR status in APO does not affect these patients' prognosis. HER2+/APO tumors tend to have a less aggressive phenotype and a more favorable outcome despite a markedly lower ER/PR positivity.

Keywords: Apocrine carcinoma; Breast cancer; HER2; Outcome; Special types.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
A, B HER2+/APO had seemingly better OS than HER2+/NST patients (A); however, the difference was not statistically significant (p = 0.264). Nevertheless, this effect was better seen in BCSS and almost reached a statistical significance (p = 0.0508) (B)
Fig. 2
Fig. 2
Overall and breast cancer-specific survival Hazard ratios. Multivariate Cox Proportion Hazards model analysis of HER2+/APO vs. HER2+/NST group. Apocrine morphology in HER2+breast cancer confers a lower hazard ratio than NST morphology (p = 0.018)
Fig. 3
Fig. 3
SR (estrogen and progesterone receptors) status had no impact on survival as there was no difference in OS and BCSS between the two APO subgroups (p = 0.304 and 0.615, respectively)
Fig. 4
Fig. 4
Apocrine morphology in HER2-enriched subgroups was associated with a better outcome in BCSS (p = 0.03), while the difference was not seen in the OS analysis (p = 0.22)
See this image and copyright information in PMC

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