Change in morphology of epithelium lining breast ducts to a secretory epithelium with granular, eosinophilic cytoplasm, single nucleolus
ER/PR(-), Bcl-2(-), AR(+)
Usually found lining dilated acini, clustered microcysts
Distinguish from columnar cell hyperplasia: Tall columnar epithelium, absent or inconspicuous nucleoli, ER(+), Bcl-2(+)
Papillary apocrine metaplasia: Cysts lined by multiple layers of apocrine-type epithelium forming papillary projections
Complex papillary AM: Microscopically forms secondary spaces with arches, may abut each other
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Image-Guided Biopsy
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Chang Sen LQ et al: Upgrade rate and imaging features of atypical apocrine lesions. Breast J. 23(5):569-578, 2017
Gao Y et al: Apocrine metaplasia found at MR biopsy: Is there something to be learned? Breast J. 23(4):429-435, 2017
Asirvatham JR et al: Atypical apocrine adenosis: Diagnostic challenges and pitfalls. Arch Pathol Lab Med. 140(10):1045-51, 2016
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
diFlorio-Alexander RM et al: Breast MRI-detected cystic apocrine metaplasia: imaging features with microvessel analysis and histologic correlation. AJR Am J Roentgenol. 204(1):211-8, 2015
Calhoun BC et al: Atypical apocrine adenosis diagnosed on breast core biopsy: implications for management. Hum Pathol. ePub, 2014
Schnitt SJ et al. Biopsy Interpretation of the Breast. 2nd ed. Philadelphia: Lippincott William & Wilkins. 54-5; 211-2; 328-9, 2013
Berg WA et al: Cystic breast lesions and the ACRIN 6666 experience. Radiol Clin North Am. 48:931-87, 2010
O'Malley FP et al: An update on apocrine lesions of the breast. Histopathology. 52(1):3-10, 2008
Wells CA et al: Non-operative breast pathology: apocrine lesions. J Clin Pathol. 60(12):1313-20, 2007
Berg WA: Sonographically depicted breast clustered microcysts: is follow-up appropriate? AJR Am J Roentgenol. 185(4):952-9, 2005
Berg WA et al: Cystic lesions of the breast: sonographic-pathologic correlation. Radiology. 227(1):183-91, 2003
Kushwaha AC et al: Mammographic-pathologic correlation of apocrine metaplasia diagnosed using vacuum-assisted stereotactic core-needle biopsy: our 4-year experience. AJR Am J Roentgenol. 180(3):795-8, 2003
Warner JK et al: Apocrine metaplasia: mammographic and sonographic appearances. AJR Am J Roentgenol. 170(5):1375-9, 1998
Page DL et al: Papillary apocrine change of the breast: associations with atypical hyperplasia and risk of breast cancer. Cancer Epidemiol Biomarkers Prev. 5(1):29-32, 1996
Seidman JD et al: Atypical apocrine adenosis of the breast: a clinicopathologic study of 37 patients with 8.7-year follow-up. Cancer. 77(12):2529-37, 1996
Tavassoli FA et al: Intraductal apocrine carcinoma: a clinicopathologic study of 37 cases. Mod Pathol. 7(8):813-8, 1994
Carter DJ et al: Atypical apocrine metaplasia in sclerosing lesions of the breast: a study of 51 patients. Mod Pathol. 4(1):1-5, 1991
Haagensen DE Jr: Is cystic disease related to breast cancer? Am J Surg Pathol. 15(7):687-94, 1991
Yates AJ et al: Apocrine carcinoma and apocrine metaplasia. Histopathology. 13(2):228-31, 1988
Wellings SR et al: Apocrine cystic metaplasia: subgross pathology and prevalence in cancer-associated versus random autopsy breasts. Hum Pathol. 18(4):381-6, 1987
Wellings SR et al: An atlas of subgross pathology of the human breast with special reference to possible precancerous lesions. J Natl Cancer Inst. 55(2):231-73, 1975
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Diagnostic Checklist
TERMINOLOGY
Abbreviations
Apocrine metaplasia (AM)
Definitions
Change in morphology of epithelium lining breast ducts to a secretory epithelium with granular, eosinophilic cytoplasm, single nucleolus
ER/PR(-), Bcl-2(-), AR(+)
Usually found lining dilated acini, clustered microcysts
Distinguish from columnar cell hyperplasia: Tall columnar epithelium, absent or inconspicuous nucleoli, ER(+), Bcl-2(+)
Papillary apocrine metaplasia: Cysts lined by multiple layers of apocrine-type epithelium forming papillary projections
Complex papillary AM: Microscopically forms secondary spaces with arches, may abut each other
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Image-Guided Biopsy
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Chang Sen LQ et al: Upgrade rate and imaging features of atypical apocrine lesions. Breast J. 23(5):569-578, 2017
Gao Y et al: Apocrine metaplasia found at MR biopsy: Is there something to be learned? Breast J. 23(4):429-435, 2017
Asirvatham JR et al: Atypical apocrine adenosis: Diagnostic challenges and pitfalls. Arch Pathol Lab Med. 140(10):1045-51, 2016
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
diFlorio-Alexander RM et al: Breast MRI-detected cystic apocrine metaplasia: imaging features with microvessel analysis and histologic correlation. AJR Am J Roentgenol. 204(1):211-8, 2015
Calhoun BC et al: Atypical apocrine adenosis diagnosed on breast core biopsy: implications for management. Hum Pathol. ePub, 2014
Schnitt SJ et al. Biopsy Interpretation of the Breast. 2nd ed. Philadelphia: Lippincott William & Wilkins. 54-5; 211-2; 328-9, 2013
Berg WA et al: Cystic breast lesions and the ACRIN 6666 experience. Radiol Clin North Am. 48:931-87, 2010
O'Malley FP et al: An update on apocrine lesions of the breast. Histopathology. 52(1):3-10, 2008
Wells CA et al: Non-operative breast pathology: apocrine lesions. J Clin Pathol. 60(12):1313-20, 2007
Berg WA: Sonographically depicted breast clustered microcysts: is follow-up appropriate? AJR Am J Roentgenol. 185(4):952-9, 2005
Berg WA et al: Cystic lesions of the breast: sonographic-pathologic correlation. Radiology. 227(1):183-91, 2003
Kushwaha AC et al: Mammographic-pathologic correlation of apocrine metaplasia diagnosed using vacuum-assisted stereotactic core-needle biopsy: our 4-year experience. AJR Am J Roentgenol. 180(3):795-8, 2003
Warner JK et al: Apocrine metaplasia: mammographic and sonographic appearances. AJR Am J Roentgenol. 170(5):1375-9, 1998
Page DL et al: Papillary apocrine change of the breast: associations with atypical hyperplasia and risk of breast cancer. Cancer Epidemiol Biomarkers Prev. 5(1):29-32, 1996
Seidman JD et al: Atypical apocrine adenosis of the breast: a clinicopathologic study of 37 patients with 8.7-year follow-up. Cancer. 77(12):2529-37, 1996
Tavassoli FA et al: Intraductal apocrine carcinoma: a clinicopathologic study of 37 cases. Mod Pathol. 7(8):813-8, 1994
Carter DJ et al: Atypical apocrine metaplasia in sclerosing lesions of the breast: a study of 51 patients. Mod Pathol. 4(1):1-5, 1991
Haagensen DE Jr: Is cystic disease related to breast cancer? Am J Surg Pathol. 15(7):687-94, 1991
Yates AJ et al: Apocrine carcinoma and apocrine metaplasia. Histopathology. 13(2):228-31, 1988
Wellings SR et al: Apocrine cystic metaplasia: subgross pathology and prevalence in cancer-associated versus random autopsy breasts. Hum Pathol. 18(4):381-6, 1987
Wellings SR et al: An atlas of subgross pathology of the human breast with special reference to possible precancerous lesions. J Natl Cancer Inst. 55(2):231-73, 1975
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