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Introduction <p>Apocrine carcinoma is a rare cancer that accounts for 0.3% to 4% of all invasive cancer cases in women. Its frequent triple-negative apocrine carcinoma (TNAC) subtype constitutes less than 1% of triple-negative breast carcinoma (TNBC) cases. TNAC lacks expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor but is positive for androgen receptor (AR) expression. Despite its aggressive nature, TNAC has a more favorable prognosis than other TNBC subtypes.</p> Case Presentation <p>We report the case of a 58-year-old Pakistani woman who presented with a painful, palpable lump in the right breast, along with peau d’orange and nipple inversion. Imaging revealed a 40 × 41&#xa0;mm spiculated mass with axillary lymphadenopathy. Intraoperative frozen section analysis was suggestive of metastatic carcinoma, prompting immediate modified radical mastectomy. Permanent histopathology confirmed triple-negative apocrine carcinoma with strong AR positivity, negative ER, PR, and HER2 expression, and a Ki-67 index above 35%. Of the 34 axillary lymph nodes removed, 3 were positive for metastasis. The patient received adjuvant chemotherapy and was scheduled for radiotherapy. Despite the aggressive histological profile, she has remained in remission for over 2&#xa0;years with no clinical or radiological evidence of recurrence.</p> Conclusion <p>This case highlights the diagnostic value of immunohistochemistry in TNAC and stresses the need for clinical awareness. Limitations include single-case data and lack of molecular profiling. Broader studies are essential to improve diagnosis, treatment, and outcomes for this rare subtype.</p>

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Uncommon Presentation of Triple Negative Apocrine Carcinoma of Breast with Lymph Node Metastasis: A Case Report and Literature Review

  • 期刊论文

  • 发表日期：

    2025年9月9日

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  • Anmol Fatima Samtio,
  • Hafsa Faisal,
  • Iqra Abdul Qadir Ahemdani

摘要

Introduction

Apocrine carcinoma is a rare cancer that accounts for 0.3% to 4% of all invasive cancer cases in women. Its frequent triple-negative apocrine carcinoma (TNAC) subtype constitutes less than 1% of triple-negative breast carcinoma (TNBC) cases. TNAC lacks expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor but is positive for androgen receptor (AR) expression. Despite its aggressive nature, TNAC has a more favorable prognosis than other TNBC subtypes.

Case Presentation

We report the case of a 58-year-old Pakistani woman who presented with a painful, palpable lump in the right breast, along with peau d’orange and nipple inversion. Imaging revealed a 40 × 41 mm spiculated mass with axillary lymphadenopathy. Intraoperative frozen section analysis was suggestive of metastatic carcinoma, prompting immediate modified radical mastectomy. Permanent histopathology confirmed triple-negative apocrine carcinoma with strong AR positivity, negative ER, PR, and HER2 expression, and a Ki-67 index above 35%. Of the 34 axillary lymph nodes removed, 3 were positive for metastasis. The patient received adjuvant chemotherapy and was scheduled for radiotherapy. Despite the aggressive histological profile, she has remained in remission for over 2 years with no clinical or radiological evidence of recurrence.

Conclusion

This case highlights the diagnostic value of immunohistochemistry in TNAC and stresses the need for clinical awareness. Limitations include single-case data and lack of molecular profiling. Broader studies are essential to improve diagnosis, treatment, and outcomes for this rare subtype.