What is the prognosis for a triple negative apocrine breast cancer?

Hi @constantinos I wanted to reply to your post because I was diagnosed with triple negative apocrine carcinoma in April 2022. I have read everything I can get my hands on. I have links for many studies if you are interested. I know that no one can give you a "prognosis" without having more information. It is very complicated and individualized. That is why your oncologist is best to answer this question. But I also know it is nice to listen to other's stories. And since I had additional testing done on my tumor that showed it was low risk to come back later I wanted to share that with you.

In my case, my tumor was 1.2cm mixed with DCIS. Lymph nodes were clear. I had a double mastectomy and no radiation or chemo. Chemo was recommended to me but I opted to have a PAM50 done to help me decide. The PAM50 showed that my risk of recurrence was 22 (low risk). The scale is 0-100 with 0-40 being low, 40-60 intermediate, and above 60 high risk. Since I was low risk and my tumor wasn't dividing very quickly I felt chemo was ok to skip. I am not recommending your wife skip chemo as her tumor was larger than mine. But I wanted you to know that some of these tumors really do have a favorable prognosis. (Side note on the PAM50 test, it is not approved for use by the doctor it is only used for research at this time. So your doctor will probably not order it. Mine would not. But I am a nurse so I found a work around through another doctor).

How can there be a lower risk triple negative cancer? Because not all triple negative cancers are the same. Most of them are "basil like" and aggressive (worse prognosis). But some of them are "luminal" and lower risk (like mine). I ended up having a luminal androgen receptor(LAR) subtype of triple negative. There is overlap between the LAR subtype and apocrine morphology. So my cancer is hormone driven much like estrogen positive cancer. But the hormone mine is 100% positive for is the androgen receptor (male hormone which women also produce). Unfortunately, it is a rare subtype and there are not any large scale studies to support changing treatment guidelines. Therefore, doctors sort of have to treat it the same as triple negative "basil like". But it appears the prognosis is more favorable in some cases. I hope some of this info helps you sort it all out. Best wishes to your wife!