J Pathol Transl Med.  2017 Jul;51(4):422-427. 10.4132/jptm.2016.11.11.

Mammary Carcinoma Arising in Microglandular Adenosis: A Report of Five Cases

• Kim M
• Kim M
• Chung YR
• Park SY

• KMID: 2392584
• DOI: http://doi.org/10.4132/jptm.2016.11.11

Abstract

Mammary carcinoma arising in microglandular adenosis (MGA) is extremely rare, and MGA is regarded as a non-obligate precursor of triple-negative breast cancer. We report five cases of carcinoma arising in MGA of the breast. All cases showed a spectrum of proliferative lesions ranging from MGA to atypical MGA, ductal carcinoma in situ or invasive carcinoma. Immunohistochemically, all cases were triple-negative and expression of S-100 protein gradually decreased as the lesions progressed from MGA to atypical MGA and carcinoma. Three cases showed acinic cell differentiation with reactivity to α1-antitrypsin, and one case was metaplastic carcinoma. During clinical follow-up, one patient developed local recurrence. Carcinoma arising in MGA is a rare but distinct subset of triple-negative breast cancer with characteristic histologic and immunohistochemical findings.

Keyword

Microglandular adenosis; Breast; Carcinoma

MeSH Terms

Acinar Cells
Breast
Carcinoma, Intraductal, Noninfiltrating
Fibrocystic Breast Disease*
Follow-Up Studies
Humans
Recurrence
S100 Proteins
Triple Negative Breast Neoplasms
S100 Proteins

Figure

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  Fig. 1. Representative histologic features of the five cases. (A, C, E, G, I) Microglandular adenosis (MGA) or atypical MGA component. (B, D, F, H, J) Carcinoma component arising in MGA in each case. (H) Histologic features of matrix forming metaplastic carcinoma. (J) Ductal carcinoma in situ (A, B, case 1; C, D, case 2; E, F, case 3; G, H, case 4; I, J, case 5).

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  Fig. 2. Acinic cell differentiation in case 3. Tumor cells have eosinophilic granular cytoplasm (A) and show immunoreactivity to α1-antitrypsin (B).

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  Fig. 3. S-100 protein and p53 expression in case 4. (A, B) Atypical microglandular adenosis (AMGA) shows diffuse strong positivity to S-100 protein (A), while carcinoma arising in microglandular adenosis (MGACA) shows decreased expression to S-100 protein (B). (C, D) p53 staining is evident in MGACA (D), but not in AMGA (C).

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