Prognosis of selected triple negative apocrine breast cancer patients who did not receive adjuvant chemotherapy.

Triple negative breast cancer encompasses several biological entities with different outcomes and is a priority to identify which patients require more treatment to reduce the risk of recurrence and which patients need less treatment. Among the 210 women with first primary invasive apocrine non metastatic breast cancer operated on between January 1998 and December 2016 at the European Institute Oncology, Milan, we identified 24 patients with a pT1-pT2, node-negative, triple negative subtype and Ki-67 ≤ 20% who did not receive adjuvant chemotherapy (CT). We compared the outcome of this cohort with a similar group of 24 patients with ductal tumors who received adjuvant chemotherapy, matched by pathological stage and biological features and also with a similar group of 12 patients with apocrine tumors who received adjuvant chemotherapy. The median age was 64 and 61 years in the apocrine (w/o CT) and ductal group, respectively. The median value of Ki-67 expression was 12% in the apocrine group (w/o CT) and 16% in the ductal group (p < 0.001). After a median follow-up of 7.5 years, no patients in the apocrine group (w/o CT) experienced a breast cancer related event compared with 4 events in the ductal carcinoma group (Gray test p-value = 0.11). The outcome of selected apocrine triple negative breast cancer patients who did not received adjuvant chemotherapy is excellent and supports a treatment de-escalation. Multicenter projects focusing on the possibility of avoiding adjuvant chemotherapy in selected subtypes of triple negative breast cancers with favorable outcome are warranted.

Copyright © 2020. Published by Elsevier Ltd.

Declaration of competing interest Emilia Montagna and Giuseppe Cancello received a honorarium for consultant/advisory role from Pierre Fabre. Elisabetta Munzone received a honorarium for consultant/advisory role from Pierre Fabre and Genomic health. Giuseppe Viale has received a honorarium for consultant/advisory role from Dako, Roche, Astellas Pharma, Novartis and he has received funding from Roche, Ventane, Dako. Marco Colleoni has received a honorarium for consultant/advisory role from Novartis, Pierre Fabre, Pfizer, Obi-Pharma, Puba biotechnology, Celldex, Astrazeneca. Eleonora Pagan, Vincenzo Bagnardi, Silvia Dellapasqua, Monica Iorfida, Manueliata Mazza, Giovanni Mazzarol, Paolo Veronesi, Viviana Galimberti, Giorgia Santomauro have no conflict of interest.