Apocrine carcinoma of the breast
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| Apocrine carcinoma of the breast | |
|---|---|
| Diagnosis in short | |
|
| |
| LM | apocrine morphology (cells with prominent nucleoli - may be multiple, abundant granular eosinophilic cytoplasm) - must be >=90% of tumour, loss of basal cells |
| LM DDx | glycogen-rich clear cell carcinoma of the breast |
| IHC | AR +ve, GCDFP-15 +ve, ER -ve, PR -ve |
| Site | breast - see invasive breast cancer |
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| |
| Prevalence | uncommon |
Apocrine carcinoma of the breast is a rare form of invasive breast cancer.
General
- Need >=90% apocrine morphology.[1]
Microscopic
Features:[1]
- Prominent nucleoli.
- Often multiple.[2]
- Abundant granular eosinophilic cytoplasm.
- Architecture like invasive ductal carcinomas no special type.
DDx:
- Glycogen-rich clear cell carcinoma of the breast.
- Cutaneous Apocrine Carcinoma
- A possible cutaneous apocrine carcinoma in a patient with a history of mammary apocrine carcinoma is problematic but fortunately a relatively infrequent conundrum.
Images
www:
Breast - Apocrine Carcinoma - Low power (SKB)
Breast - Apocrine Carcinoma - Perineural invasion - High power (SKB)
Breast - Apocrine Carcinoma - Low power (SKB)
Breast - Apocrine Carcinoma - Medium power (SKB)
Breast - Apocrine Carcinoma - High power (SKB)
Breast - Apocrine Carcinoma - High power (SKB)
IHC
Smaller tumours classically:[3]
- AR +ve.
- GCDFP-15 +ve.
Usually:[1]
- ER -ve.
- PR -ve.
- Her2 -ve
Notes
- Salivary gland carcinoma and cutaneous adnexal tumors can show a similar IHC profile.
- Apocrine carcioma is a non-basal type 'triple negative carcinoma' identified by both morphology and AR positivity[4].
- May show different behaviour to other types of triple negative carcinoma
- May respond to different treatments
See also
References
- ↑ 1.0 1.1 1.2 O'Malley, Frances P.; Pinder, Sarah E. (2006). Breast Pathology: A Volume in Foundations in Diagnostic Pathology series (1st ed.). Churchill Livingstone. pp. 217. ISBN 978-0443066801.
- ↑ O'Malley, FP.; Bane, A. (Jan 2008). "An update on apocrine lesions of the breast.". Histopathology 52 (1): 3-10. doi:10.1111/j.1365-2559.2007.02888.x. PMID 18171412.
- ↑ Honma, N.; Takubo, K.; Akiyama, F.; Sawabe, M.; Arai, T.; Younes, M.; Kasumi, F.; Sakamoto, G. (Aug 2005). "Expression of GCDFP-15 and AR decreases in larger or node-positive apocrine carcinomas of the breast.". Histopathology 47 (2): 195-201. doi:10.1111/j.1365-2559.2005.02181.x. PMID 16045781.
- ↑ Tsutsumi, Y. (May 2012). "Apocrine carcinoma as triple-negative breast cancer: novel definition of apocrine-type carcinoma as estrogen/progesterone receptor-negative and androgen receptor-positive invasive ductal carcinoma.". Jpn J Clin Oncol 42 (5): 375-86. doi:10.1093/jjco/hys034. PMID 22450930.