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Apocrine Carcinoma
Lauren Q. Chang Sen, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Apocrine ductal carcinoma in situ (ADCIS)
              • Invasive apocrine carcinoma (IAC)
            • Definitions

              • ADCIS: DCIS characterized by apocrine cell proliferation; no consensus classification; proposed histologic grading system for ADCIS based on nuclear grade ± comedo-type necrosis
              • Pure IAC: Architectural growth pattern same as invasive ductal carcinoma (IDC), no special type (NST), with apocrine cytologic features (voluminous eosinophilic granular cytoplasm, round nuclei with prominent, often multiple, nucleoli) in all or nearly all (> 90%) of epithelium; not special type of IDC per se

            IMAGING

            • General Features

              • Mammographic Findings

                • Ultrasonographic Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • Staging, Grading, & Classification

                          • Microscopic Features

                            • Molecular Features and Biomarkers

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Image Interpretation Pearls

                                        • Reporting Tips

                                          Selected References

                                          1. Meattini I et al: Triple negative apocrine carcinomas as a distinct subtype of triple negative breast cancer: A case-control study. Clin Breast Cancer. 18(5):e773-e780, 2018
                                          2. Oshilaja O et al: Androgen receptors in resected ductal carcinoma in situ of breast: Novel insights with possible implications for testing and targeted endocrine chemoprevention trials. Appl Immunohistochem Mol Morphol. ePub, 2018
                                          3. Zhao S et al: Clinicopathologic features and prognoses of different histologic types of triple-negative breast cancer: A large population-based analysis. Eur J Surg Oncol. 44(4):420-428, 2018
                                          4. Chang Sen LQ et al: Upgrade rate and imaging features of atypical apocrine lesions. Breast J. 23(5):569-578, 2017
                                          5. Kővári B et al: The expression of GHRH and its receptors in breast carcinomas with apocrine differentiation-further evidence of the presence of a GHRH pathway in these tumors. Hum Pathol. 64:164-170, 2017
                                          6. Seo KJ et al: Apocrine ductal carcinoma in situ presenting as a large, cystic breast mass: An uncommon presentation of a rare breast lesion. Breast J. 23(5):594-595, 2017
                                          7. Vranic S et al: Apocrine carcinoma of the breast: A brief update on the molecular features and targetable biomarkers. Bosn J Basic Med Sci. 17(1):9-11, 2017
                                          8. Hou Y et al: Surgical follow-up results for apocrine adenosis and atypical apocrine adenosis diagnosed on breast core biopsy. Ann Diagn Pathol. 24:4-6, 2016
                                          9. Mills AM et al: Pure apocrine carcinomas represent a clinicopathologically distinct androgen receptor-positive subset of triple-negative breast cancers. Am J Surg Pathol. 40(8):1109-16, 2016
                                          10. Tajima S et al: Cystic apocrine ductal carcinoma in situ with increased EGFR expression, trisomy 7, and associated focal invasion. Med Mol Morphol. 49(3):170-6, 2016
                                          11. Gromov P et al: Molecular and diagnostic features of apocrine breast lesions. Expert Rev Mol Diagn. 15(8):1011-22, 2015
                                          12. Seo KJ et al: Sonography of Invasive Apocrine Carcinoma of the Breast in Five Cases. Korean J Radiol. 16(5):1006-11, 2015
                                          13. Calhoun BC et al: Atypical apocrine adenosis diagnosed on breast core biopsy: implications for management. Hum Pathol. ePub, 2014
                                          14. Dellapasqua S et al: Immunohistochemically defined subtypes and outcome of apocrine breast cancer. Clin Breast Cancer. 13(2):95-102, 2013
                                          15. Dreyer G et al: Triple negative breast cancer: clinical characteristics in the different histological subtypes. Breast. 22(5):761-6, 2013
                                          16. Montagna E et al: Heterogeneity of triple-negative breast cancer: histologic subtyping to inform the outcome. Clin Breast Cancer. 13(1):31-9, 2013
                                          17. Vranic S et al: Apocrine carcinoma of the breast: a comprehensive review. Histol Histopathol. 28(11):1393-409, 2013
                                          18. Cha YJ et al: The clinicopathologic features of molecular apocrine breast cancer. Korean J Pathol. 46(2):169-76, 2012
                                          19. Choi J et al: Clinicopathologic features of molecular subtypes of triple negative breast cancer based on immunohistochemical markers. Histol Histopathol. 27(11):1481-93, 2012
                                          20. Gerhard R et al: Benign and malignant apocrine lesions of the breast. Expert Rev Anticancer Ther. 12(2):215-21, 2012
                                          21. Nagao T et al: The differences in the histological types of breast cancer and the response to neoadjuvant chemotherapy: the relationship between the outcome and the clinicopathological characteristics. Breast. 21(3):289-95, 2012
                                          22. Iwase H et al: Clinicopathological analyses of triple negative breast cancer using surveillance data from the Registration Committee of the Japanese Breast Cancer Society. Breast Cancer. 17(2):118-24, 2010
                                          23. O'Malley FP et al: An update on apocrine lesions of the breast. Histopathology. 52(1):3-10, 2008
                                          24. Tanaka K et al: Invasive apocrine carcinoma of the breast: clinicopathologic features of 57 patients. Breast J. 14(2):164-8, 2008
                                          25. Wells CA and El-Ayat GA: Non-operative breast pathology: apocrine lesions. J Clin Pathol. 60:1313-20, 2007
                                          26. Japaze H et al: 'Pure' invasive apocrine carcinoma of the breast: a new clinicopathological entity? Breast. 14(1):3-10, 2005
                                          27. Takeuchi H et al: Clinicopathological feature and long-term prognosis of apocrine carcinoma of the breast in Japanese women. Breast Cancer Res Treat. 88(1):49-54, 2004
                                          28. Leal C et al: Apocrine ductal carcinoma in situ of the breast: histologic classification and expression of biologic markers. Hum Pathol. 32(5):487-93, 2001
                                          29. Matsuo K et al: Apocrine Carcinoma of the Breast: Clinicopathological Analysis and Histological Subclassification of 12 Cases. Breast Cancer. 5(3):279-284, 1998
                                          30. Gilles R et al: Apocrine carcinoma: clinical and mammographic features. Radiology. 190(2):495-7, 1994
                                          31. Abati AD et al: Apocrine mammary carcinoma. A clinicopathologic study of 72 cases. Am J Clin Pathol. 94(4):371-7, 1990
                                          32. Aoyagi H et al: [Ten cases of an apocrine carcinoma of the breast and a review of cases in the Japanese literature.] Gan No Rinsho. 36(6):681-90, 1990
                                          33. d'Amore ES et al: Invasive apocrine carcinoma of the breast: a long term follow-up study of 34 cases. Breast Cancer Res Treat. 12(1):37-44, 1988
                                          34. Frable WJ et al: Carcinoma of the breast. Histologic and clinical features of apocrine tumors. Cancer. 21(4):756-63, 1968
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Pathology

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Apocrine ductal carcinoma in situ (ADCIS)
                                                      • Invasive apocrine carcinoma (IAC)
                                                    • Definitions

                                                      • ADCIS: DCIS characterized by apocrine cell proliferation; no consensus classification; proposed histologic grading system for ADCIS based on nuclear grade ± comedo-type necrosis
                                                      • Pure IAC: Architectural growth pattern same as invasive ductal carcinoma (IDC), no special type (NST), with apocrine cytologic features (voluminous eosinophilic granular cytoplasm, round nuclei with prominent, often multiple, nucleoli) in all or nearly all (> 90%) of epithelium; not special type of IDC per se

                                                    IMAGING

                                                    • General Features

                                                      • Mammographic Findings

                                                        • Ultrasonographic Findings

                                                          • MR Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • Staging, Grading, & Classification

                                                                  • Microscopic Features

                                                                    • Molecular Features and Biomarkers

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Image Interpretation Pearls

                                                                                • Reporting Tips

                                                                                  Selected References

                                                                                  1. Meattini I et al: Triple negative apocrine carcinomas as a distinct subtype of triple negative breast cancer: A case-control study. Clin Breast Cancer. 18(5):e773-e780, 2018
                                                                                  2. Oshilaja O et al: Androgen receptors in resected ductal carcinoma in situ of breast: Novel insights with possible implications for testing and targeted endocrine chemoprevention trials. Appl Immunohistochem Mol Morphol. ePub, 2018
                                                                                  3. Zhao S et al: Clinicopathologic features and prognoses of different histologic types of triple-negative breast cancer: A large population-based analysis. Eur J Surg Oncol. 44(4):420-428, 2018
                                                                                  4. Chang Sen LQ et al: Upgrade rate and imaging features of atypical apocrine lesions. Breast J. 23(5):569-578, 2017
                                                                                  5. Kővári B et al: The expression of GHRH and its receptors in breast carcinomas with apocrine differentiation-further evidence of the presence of a GHRH pathway in these tumors. Hum Pathol. 64:164-170, 2017
                                                                                  6. Seo KJ et al: Apocrine ductal carcinoma in situ presenting as a large, cystic breast mass: An uncommon presentation of a rare breast lesion. Breast J. 23(5):594-595, 2017
                                                                                  7. Vranic S et al: Apocrine carcinoma of the breast: A brief update on the molecular features and targetable biomarkers. Bosn J Basic Med Sci. 17(1):9-11, 2017
                                                                                  8. Hou Y et al: Surgical follow-up results for apocrine adenosis and atypical apocrine adenosis diagnosed on breast core biopsy. Ann Diagn Pathol. 24:4-6, 2016
                                                                                  9. Mills AM et al: Pure apocrine carcinomas represent a clinicopathologically distinct androgen receptor-positive subset of triple-negative breast cancers. Am J Surg Pathol. 40(8):1109-16, 2016
                                                                                  10. Tajima S et al: Cystic apocrine ductal carcinoma in situ with increased EGFR expression, trisomy 7, and associated focal invasion. Med Mol Morphol. 49(3):170-6, 2016
                                                                                  11. Gromov P et al: Molecular and diagnostic features of apocrine breast lesions. Expert Rev Mol Diagn. 15(8):1011-22, 2015
                                                                                  12. Seo KJ et al: Sonography of Invasive Apocrine Carcinoma of the Breast in Five Cases. Korean J Radiol. 16(5):1006-11, 2015
                                                                                  13. Calhoun BC et al: Atypical apocrine adenosis diagnosed on breast core biopsy: implications for management. Hum Pathol. ePub, 2014
                                                                                  14. Dellapasqua S et al: Immunohistochemically defined subtypes and outcome of apocrine breast cancer. Clin Breast Cancer. 13(2):95-102, 2013
                                                                                  15. Dreyer G et al: Triple negative breast cancer: clinical characteristics in the different histological subtypes. Breast. 22(5):761-6, 2013
                                                                                  16. Montagna E et al: Heterogeneity of triple-negative breast cancer: histologic subtyping to inform the outcome. Clin Breast Cancer. 13(1):31-9, 2013
                                                                                  17. Vranic S et al: Apocrine carcinoma of the breast: a comprehensive review. Histol Histopathol. 28(11):1393-409, 2013
                                                                                  18. Cha YJ et al: The clinicopathologic features of molecular apocrine breast cancer. Korean J Pathol. 46(2):169-76, 2012
                                                                                  19. Choi J et al: Clinicopathologic features of molecular subtypes of triple negative breast cancer based on immunohistochemical markers. Histol Histopathol. 27(11):1481-93, 2012
                                                                                  20. Gerhard R et al: Benign and malignant apocrine lesions of the breast. Expert Rev Anticancer Ther. 12(2):215-21, 2012
                                                                                  21. Nagao T et al: The differences in the histological types of breast cancer and the response to neoadjuvant chemotherapy: the relationship between the outcome and the clinicopathological characteristics. Breast. 21(3):289-95, 2012
                                                                                  22. Iwase H et al: Clinicopathological analyses of triple negative breast cancer using surveillance data from the Registration Committee of the Japanese Breast Cancer Society. Breast Cancer. 17(2):118-24, 2010
                                                                                  23. O'Malley FP et al: An update on apocrine lesions of the breast. Histopathology. 52(1):3-10, 2008
                                                                                  24. Tanaka K et al: Invasive apocrine carcinoma of the breast: clinicopathologic features of 57 patients. Breast J. 14(2):164-8, 2008
                                                                                  25. Wells CA and El-Ayat GA: Non-operative breast pathology: apocrine lesions. J Clin Pathol. 60:1313-20, 2007
                                                                                  26. Japaze H et al: 'Pure' invasive apocrine carcinoma of the breast: a new clinicopathological entity? Breast. 14(1):3-10, 2005
                                                                                  27. Takeuchi H et al: Clinicopathological feature and long-term prognosis of apocrine carcinoma of the breast in Japanese women. Breast Cancer Res Treat. 88(1):49-54, 2004
                                                                                  28. Leal C et al: Apocrine ductal carcinoma in situ of the breast: histologic classification and expression of biologic markers. Hum Pathol. 32(5):487-93, 2001
                                                                                  29. Matsuo K et al: Apocrine Carcinoma of the Breast: Clinicopathological Analysis and Histological Subclassification of 12 Cases. Breast Cancer. 5(3):279-284, 1998
                                                                                  30. Gilles R et al: Apocrine carcinoma: clinical and mammographic features. Radiology. 190(2):495-7, 1994
                                                                                  31. Abati AD et al: Apocrine mammary carcinoma. A clinicopathologic study of 72 cases. Am J Clin Pathol. 94(4):371-7, 1990
                                                                                  32. Aoyagi H et al: [Ten cases of an apocrine carcinoma of the breast and a review of cases in the Japanese literature.] Gan No Rinsho. 36(6):681-90, 1990
                                                                                  33. d'Amore ES et al: Invasive apocrine carcinoma of the breast: a long term follow-up study of 34 cases. Breast Cancer Res Treat. 12(1):37-44, 1988
                                                                                  34. Frable WJ et al: Carcinoma of the breast. Histologic and clinical features of apocrine tumors. Cancer. 21(4):756-63, 1968