World J Oncol

World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access

Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc

Journal website https://www.wjon.org

Original Article

Volume 14, Number 6, December 2023, pages 551-557

Clinicopathological Characteristics and Prognosis of Triple-Negative Apocrine Carcinoma: A Case-Control Study

Figure 1. Hematoxylin and eosin (a) and nuclear AR (b) staining images of a representative TN-PAC case. TN-PAC: triple-negative pure apocrine carcinoma; AR: androgen receptor.

Figure 2. Flowchart for diagnosis of triple-negative pure apocrine carcinoma (TN-PAC). TNBC: triple-negative breast cancer; AC: apocrine carcinoma; AR: androgen receptor.

Figure 3. The TN-PAC group showed no recurrence or death from breast cancer during the observation period, and the recurrence rate in the TN-PAC group was significantly lower than that in the other-AC group. Kaplan-Meier curves for relapse-free survival (a) and breast cancer-specific survival (b). Solid line indicates TN-PAC, and dotted line indicates other-AC. P values were calculated using the log-rank test. AC: apocrine carcinoma; TN-PAC: triple-negative pure apocrine carcinoma.

**Table 1.** Comparison of Clinicopathological Characteristics in TN-PAC Patients With Other-AC Patients
	All cohort (N = 53)	TN-PAC (N = 24)	Other-AC (N = 29)	P-value
AC: apocrine carcinoma; Ax: axillary lymph node dissection; BCS: breast conserving surgery; HER2: human epidermal growth factor receptor 2; NA: not assessed; PAC: pure apocrine carcinoma; SNB: sentinel lymph node biopsy; TN: triple-negative; TN-PAC: triple-negative pure apocrine carcinoma.
Median age, years (min. - max.)	67 (43 - 94)	71 (48 - 81)	64 (43 - 94)	0.108
Hormonal status, N (%)
Pre-menopausal	5 (9.4)	3 (12.5)	2 (6.9)	0.446
Post-menopausal	44 (83.0)	20 (83.3)	24 (82.8)
NA	4 (7.6)	1 (4.2)	3 (10.3)
Median tumor size, cm (min. - max.)	2.2 (0.5 - 10.0)	1.4 (0.5 - 8.0)	2.1 (1.1 - 10.0)	0.024
Pathological node status, N (%)
Positive	14 (26.4)	3 (12.5)	11 (37.9)	0.036
Negative	39 (73.6)	21 (87.5)	18 (62.1)
Median Ki-67 index (min. - max.)	0 - 70	5 (0 - 70)	6.5 (0 - 60)	0.855
Nuclear grade, N (%)
1	12 (22.6)	6 (25.0)	6 (20.7)	0.197
2	14 (26.4)	10 (41.7)	4 (13.8)
3	19 (35.9)	6 (25.0)	13 (44.8)
NA	8 (15.1)	1 (4.2)	6 (20.7)
Estrogen receptor status, N (%)
Positive	13 (24.5)	0 (0)	13 (44.8)	< 0.001
Negative	40 (75.5)	24 (100)	16 (55.2)
Progesterone receptor status, N (%)
Positive	10 (18.9)	0 (0)	10 (34.4)	< 0.001
Negative	43 (81.1)	24 (100)	19 (65.6)
HER2 status, N (%)
Positive	11 (20.8)	0 (0)	11 (37.9)	< 0.001
Negative	41 (77.4)	24 (100)	17 (58.6)
NA	1 (1.9)	0 (0)	1 (3.5)
TN subtype, No. (%)
Yes	31 (58.5)	24 (100)	7 (24.1)	< 0.001
No	22 (41.5)	0 (0)	22 (75.9)
AR status, N (%)
Positive	42 (79.2)	24 (100)	18 (62.1)	< 0.001
Negative	11 (20.8)	0 (0)	11 (37.9)
Breast cancer stage, N (%)
I	24 (45.3)	14 (58.3)	10 (34.5)	0.157
II	21 (39.6)	9 (39.0)	12 (41.4)
III	7 (13.2)	1 (4.2)	6 (20.7)
IV	1 (1.9)	0 (0.0)	1 (3.4)
Breast surgery, N (%)
BCS	22 (41.5)	11 (45.8)	11 (37.9)	0.588
Mastectomy	31 (58.5)	13 (54.2)	18 (62.1)
Axillary surgery, N (%)
SNB	32 (60.4)	19 (79.2)	13 (44.8)	0.013
Ax	21 (39.5)	5 (20.8)	16 (55.2)
Systemic therapy received, N (%)
Yes	35 (66.0)	12 (50.0)	23 (79.3)	0.038
No	17 (32.1)	11 (45.8)	6 (20.7)
NA	1 (1.9)	1 (4.2)	0 (0.0)
Chemotherapy received, N (%)
Yes	28 (52.8)	12 (50.0)	16 (55.2)	0.525
No	24 (45.3)	11 (45.8)	13 (44.8)
NA	1 (1.9)	1 (4.2)	0 (0.0)
Relapse, N (%)	5 (9.4)	0 (0.0)	5 (17.2)	0.041
All-cause mortality, N (%)	6 (11.3)	2 (8.3)	4 (13.8)	0.678
Breast-cancer mortality, N (%)	4 (7.5)	0 (0.0)	4 (13.8)	0.081

Table 1. Comparison of Clinicopathological Characteristics in TN-PAC Patients With Other-AC Patients

All cohort (N = 53)

TN-PAC (N = 24)

Other-AC (N = 29)

P-value

AC: apocrine carcinoma; Ax: axillary lymph node dissection; BCS: breast conserving surgery; HER2: human epidermal growth factor receptor 2; NA: not assessed; PAC: pure apocrine carcinoma; SNB: sentinel lymph node biopsy; TN: triple-negative; TN-PAC: triple-negative pure apocrine carcinoma.

Median age, years (min. - max.)

67 (43 - 94)

71 (48 - 81)

64 (43 - 94)

0.108

Hormonal status, N (%)

Pre-menopausal

5 (9.4)

3 (12.5)

2 (6.9)

0.446

Post-menopausal

44 (83.0)

20 (83.3)

24 (82.8)

4 (7.6)

1 (4.2)

3 (10.3)

Median tumor size, cm (min. - max.)

2.2 (0.5 - 10.0)

1.4 (0.5 - 8.0)

2.1 (1.1 - 10.0)

0.024

Pathological node status, N (%)

Positive

14 (26.4)

3 (12.5)

11 (37.9)

0.036

Negative

39 (73.6)

21 (87.5)

18 (62.1)

Median Ki-67 index (min. - max.)

0 - 70

5 (0 - 70)

6.5 (0 - 60)

0.855

Nuclear grade, N (%)

12 (22.6)

6 (25.0)

6 (20.7)

0.197

14 (26.4)

10 (41.7)

4 (13.8)

19 (35.9)

6 (25.0)

13 (44.8)

8 (15.1)

1 (4.2)

6 (20.7)

Estrogen receptor status, N (%)

Positive

13 (24.5)

0 (0)

13 (44.8)

< 0.001

Negative

40 (75.5)

24 (100)

16 (55.2)

Progesterone receptor status, N (%)

Positive

10 (18.9)

0 (0)

10 (34.4)

< 0.001

Negative

43 (81.1)

24 (100)

19 (65.6)

HER2 status, N (%)

Positive

11 (20.8)

0 (0)

11 (37.9)

< 0.001

Negative

41 (77.4)

24 (100)

17 (58.6)

1 (1.9)

0 (0)

1 (3.5)

TN subtype, No. (%)

Yes

31 (58.5)

24 (100)

7 (24.1)

< 0.001

22 (41.5)

0 (0)

22 (75.9)

AR status, N (%)

Positive

42 (79.2)

24 (100)

18 (62.1)

< 0.001

Negative

11 (20.8)

0 (0)

11 (37.9)

Breast cancer stage, N (%)

24 (45.3)

14 (58.3)

10 (34.5)

0.157

21 (39.6)

9 (39.0)

12 (41.4)

III

7 (13.2)

1 (4.2)

6 (20.7)

1 (1.9)

0 (0.0)

1 (3.4)

Breast surgery, N (%)

BCS

22 (41.5)

11 (45.8)

11 (37.9)

0.588

Mastectomy

31 (58.5)

13 (54.2)

18 (62.1)

Axillary surgery, N (%)

SNB

32 (60.4)

19 (79.2)

13 (44.8)

0.013

21 (39.5)

5 (20.8)

16 (55.2)

Systemic therapy received, N (%)

Yes

35 (66.0)

12 (50.0)

23 (79.3)

0.038

17 (32.1)

11 (45.8)

6 (20.7)

1 (1.9)

1 (4.2)

0 (0.0)

Chemotherapy received, N (%)

Yes

28 (52.8)

12 (50.0)

16 (55.2)

0.525

24 (45.3)

11 (45.8)

13 (44.8)

1 (1.9)

1 (4.2)

0 (0.0)

Relapse, N (%)

5 (9.4)

0 (0.0)

5 (17.2)

0.041

All-cause mortality, N (%)

6 (11.3)

2 (8.3)

4 (13.8)

0.678

Breast-cancer mortality, N (%)

4 (7.5)

0 (0.0)

4 (13.8)

0.081