Kadri Altundag
MKA Breast Cancer Clinic, Tepe Prime, Ankara, Turkey.
Abstract
Dear Editor,
Invasive apocrine carcinoma is a rare breast cancer that is frequently triple negative. Little is known about the characteristics of its molecular subtypes. Apocrine carcinoma, a subtype of invasive ductal carcinoma of the breast, also expresses androgen receptor (AR). Triple-negative apocrine adenocarcinomas have a modestly improved long-term survival when compared with triple-negative invasive ductal cancers [1,2]. A 48-year-old woman was diagnosed with left breast triple-negative apocrine carcinoma and underwent left modified radical mastectomy with stage T2N2M0 disease in January 2008. Her tumor expressed androgen receptor (AR) and Ki 67 was 10% as well. She received four cycles of adriamycin-cyclophosphamide followed by four cylcles of docetaxel. She then received adjuvant radiotherapy. She was on remission. BRCA status was not known at that time. She came to the clinic with right axillary lymphadenopathy in May 2013. Trucut biopsy showed metastatic triple-negative apocrine breast cancer with AR expression. Metastatic workup did not reveal metastasis including right breast other than right axillary lymph node. Then she received 4 cyles of docetaxel and capecitabine followed by radiotherapy to right axillary region with complete remission. Surgery was not performed at all. While she was in remission for about 8 years, due to CA 125 and CEA tumor marker elevation, detailed metastatic work-up was performed showing metastatic left pleural metastatic nodules in November 2021. Trucut biopsy reported again metastatic triple-negative apocrine breast cancer with AR expression. Weekly paclitaxel was planned to be initiated. In conclusion, patients with triple-negative apocrine carcinoma had a better prognosis than patients with triple-negative breast cancer, and chemotherapy was associated with survival advantage in triple-negative apocrine carcinoma patients [3].
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