J Breast Cancer.  2008 Dec;11(4):201-205. 10.4048/jbc.2008.11.4.201.

Apocrine Carcinoma of the Breast: Clinicopathologic Analysis of 19 Cases

• Sung MK
• Noh WC
• Kim MS
• Kim HA
• Paik NS
• Moon NM
• Kim YH

• KMID: 2286586
• DOI: http://doi.org/10.4048/jbc.2008.11.4.201

Abstract

PURPOSE: Apocrine carcinoma of the breast, a specific histologic type of human breast cancer, is a rare malignant tumor. Because of the rarity of apocrine carcinoma and lack of a standardized definition, the clinicopathologic features have not been definitively determined. In this study, we present a single institution analysis of the clinicopathologic features of 19 cases of apocrine carcinoma and contrast them with those seen in infiltrating ductal carcinoma, not otherwise specified (NOS).
METHODS
We respectively reviewed the records of 19 patients with apocrine carcinoma who underwent surgery at Korea Cancer Center Hospital between October 1997 and April 2007.
RESULTS
The mean patient age was 52.8 years. Eight patients (42.1%) were under 50 years of age. In all patients, the initial symptom was a breast mass. Twelve (63.2%) of 19 tumors were located in the right breast and the other 7 cases (36.8%) were located in the left breast. The average tumor size was 2.19 cm (range 0.7-7 cm). Two patients had axillary lymph node metastasis. Estrogen receptor (ER) was positive in 3 cases (16.7%). The HER-2 overexpression rate was 35.3%. There was no locoreginal recurrence, distant metastasis, or death during the median follow-up period of 35.4 months (range 4-114 months).
CONCLUSION
Compared with the alleged characteristics seen in Korean breast cancer patients, apocrine carcinoma was characterized by an older age at the time of diagnosis and a higher incidence of hormone receptor negatively. The HER-2 overexpression rate was similar to the rate for other tumors. Although there was a relatively low incidence ER positivity, there was no recurrence or death. Therefore, apocrine carcinoma appears to be clinically distinct from infiltrating ductal carcinoma, NOS.

Keyword

Breast; Carcinoma; Apocrine

MeSH Terms

Breast
Breast Neoplasms
Carcinoma, Ductal
Estrogens
Follow-Up Studies
Humans
Incidence
Korea
Lymph Nodes
Neoplasm Metastasis
Recurrence
Estrogens

Figure

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  Fig 1 Invasive apocrine carcinoma. (A) Gross finding of apocrine carcinoma showed a 2×3 cm sized, well-circumscribed whitish gray mass, (B, C) Carcinoma characterized by well circumscribed margin, large tumor cells with relatively dense cytoplasm and large, hyperchromatic nuclei (HE stain ×40 [B], ×400 [C]).

Reference

1. Azzopardi JG. Problems in breast pathology, Major problems in pathology. 1979. 11th ed. Lodon: WB saunders.

2. Jung KH, Lee US, Bae JW, Koo BH. Apocrine carcinoma of the breast: the report of 2 cases. J Korean Surgical Soc. 1997. 52:755–759.

3. Shin YD, Ko YG, Park HC, Koh SH, Yoon C. Three cases of apocrine carcinoma. J Korean Surgical Soc. 1996. 50:602–607.

4. Tanaka K, Imoto S, Wada N, Sakemura N, Hasebe K. Invasive apocrine carcinoma of the breast: clinicopathologic features of 57 patients. Breast J. 2008. 14:164–168.

5. Japaze H, Emina J, Diaz C, Schwam RJ, Gercovich N, Demonty G, et al. 'Pure' invasive apocrine carcinoma of the breast: a new clinicopathological entity? Breast. 2005. 14:3–10.

6. Frable WJ, Kay S. Carcinoma of the breast. Histologic and clinical features of apocrine tumors. Cancer. 1968. 21:756–763.

7. Tavassoli FA, Devilee D. World Health Organization Classification of Tumours: pathology and genetics. Tumours of the breast and female genital organs. 2003. 1st ed. Lyon: IARC Press.

8. Tavassoli FA, Norris HJ. Intraductal apocrine carcinoma: a clinicopathologic study of 37 cases. Mod Pathol. 1994. 7:813–818.

9. Honma N, Takubo K, Akiyama F, Sawabe M, Arai T, Younes M, et al. Expression of GCDFP-15 and AR decreases in larger or node-positive apocrine carcinomas of the breast. Histopathology. 2005. 47:195–201.

10. Mazoujian G, Pinkus GS, Davis S, Haagensen DE Jr. Immunohistochemistry of a gross cystic disease fluid protein (GCDFP-15) of the breast. A marker of apocrine epithelium and breast carcinomas with apocrine features. Am J Pathol. 1983. 110:105–112.

11. Mazoujian G, Bodian C, Haagensen DE Jr, Haagensen CD. Expression of GCDFP-15 in breast carcinomas. Relationship to pathologic and clinical factors. Cancer. 1989. 63:2156–2161.

12. Eusebi V, Millis RR, Cattani MG, Bussolati G, Azzopardi JG. Apocrine carcinoma of the breast. A morphologic and immunocytochemical study. Am J Pathol. 1986. 123:532–541.

13. Abati AD, Kimmel M, Rosen PP. Apocrine mammary carcinoma. A clinicopathologic study of 72 cases. Am J Clin Pathol. 1990. 94:371–377.

14. d'Amore ES, Terrier-Lacombe MJ, Travagli JP, Friedman S, Contesso G. Invasive apocrine carcinoma of the breast: a long term follow-up study of 34 cases. Breast Cancer Res Treat. 1988. 12:37–44.

15. Jeong J. Nationwide Korean breast cancer data of 2004 using breast cancer registration program. the Korean Breast Cancer Society. J Breast Cancer. 2006. 9:151–161.

16. Mossler JA, Barton TK, Brinkhous AD, McCarty KS, Moylan JA, McCarty KS Jr. Apocrine differentiation in human mammary carcinoma. Cancer. 1980. 46:2463–2471.

17. Matsuo K, Fukutomi T, Tsuda H, Kanai Y, Tanaka SA, Nanasawa T. Apocrine Carcinoma of the Breast: clinicopathological analysis and histological subclassification of 12 cases. Breast Cancer. 1998. 5:279–284.

18. Honma N, Sakamoto G, Akiyama F, Esaki Y, Sawabe M, Arai T, et al. Breast carcinoma in women over the age of 85: distinct histological pattern and androgen, oestrogen, and progesterone receptor status. Histopathology. 2003. 42:120–127.

19. Leal C, Henrique R, Monteiro P, Lopes C, Bento MJ, De Sousa CP, et al. Apocrine ductal carcinoma in situ of the breast: histologic classification and expression of biologic markers. Hum Pathol. 2001. 32:487–493.

20. Gatalica Z. Immunohistochemical analysis of apocrine breast lesions. Consistent over-expression of androgen receptor accompanied by the loss of estrogen and progesterone receptors in apocrine metaplasia and apocrine carcinoma in situ. Pathol Res Pract. 1997. 193:753–758.

21. Shim HS, Jung WH, Kim H, Park K, Cho NH. Expression of androgen receptors and inhibin/activin alpha and betaA subunits in breast apocrine lesions. APMIS. 2006. 114:352–358.

22. Matsuo K, Fukutomi T, Hasegawa T, Akashi-Tanaka S, Nanasawa T, Tsuda H. Histological and immunohistochemical analysis of apocrine breast carcinoma. Breast Cancer. 2002. 9:43–49.

23. Takeuchi H, Tsuji K, Ueo H, Kano T, Maehara Y. Clinicopathological feature and long-term prognosis of apocrine carcinoma of the breast in Japanese women. Breast Cancer Res Treat. 2004. 88:49–54.