Apocrine Carcinoma Of Breast Research Articles

Clinical, histological and receptor profiles of invasive breast cancer and ductal carcinoma in situ in females with germline pathogenic variants in PTEN and implications for germline testing

PTEN hamartoma tumour syndrome (PHTS) is an autosomal dominant hereditary cancer syndrome, caused mostly by germline pathogenic variants in PTEN. Female carriers have an up to 80% lifetime risk of breast cancer. Pathologic features of breast cancer in PHTS have seldom been reported.In a collaboration between all histopathology laboratories in our state and our statewide familial cancer service, we tracked the breast biopsies of 12 females with known PTEN pathogenic or likely pathogenic variants (Jan 1990 to Jan 2018). Two further cases were added by a Victorian cancer genetics unit.Breast cancer, inclusive of invasive cancer or ductal carcinoma in situ (DCIS), was diagnosed in 12 of 14 cases (85.7%). One case had a family history of PHTS and six a family history of breast cancer. The mean age at first breast cancer diagnosis was 41.6 years (range 27-63). Six cases developed more than one breast cancer. Five (42%) developed contralateral breast cancer. Ten of the 12 invasive cancers were of no special type, two were reported as lobular carcinomas. None were grade 1. When reported, all cancers were hormone receptor positive and HER2 negative. All were associated with DCIS. The DCIS spanned all grades.The two cases without breast cancer still required surgery for exuberant benign changes, including papillomas, fibroadenomatoid change, florid ductal epithelial hyperplasia, adenosis and stromal fibrosis.We note that the morphology and receptor profiles of breast cancer in individuals with P/LP PTEN variants are not distinctive. Contrary to prevalent beliefs, these cancers do not conform to the contemporary definition of apocrine breast carcinoma. Greater familiarity of healthcare professionals with the overall clinical and pathologic findings in PHTS and the validated Cleveland Clinic PTEN calculator (http://www.lerner.ccf.org/gmi/ccscore) would improve the recognition of female PHTS individuals with breast cancer. Earlier identification of their cancer predisposition syndrome would benefit these patients and their families who are at high risk of a range of cancers.

Breast apocrine carcinoma: a case report and review of literature

Breast apocrine carcinoma: a case report and review of literature

Radiological Particularities of Apocrine Breast Carcinoma: A Case Study and Literature Review

Apocrine carcinoma is a rare form of breast carcinoma. We report the case of a 35-year-old female with a tumor over 4 cm in the major axis located in the inner median quadrant of the right breast. Mammography revealed a breast mass hosting microcalcification. Breast ultrasound highlighted three suspect masses requiring histological verification by micro biopsy; histological diagnosis favored apocrine carcinoma.

P245 Apocrine breast carcinoma. a single institution experience and literature review

P245 Apocrine breast carcinoma. a single institution experience and literature review

Distinct Uroplakin II Staining Pattern in Apocrine Breast Carcinoma.

Uroplakin II (UPII) has been shown as a highly specific marker of urothelial carcinoma; however, it can also stain subtypes of apocrine-differentiated breast carcinoma. Given that urothelium and breast epithelium share other common immunohistochemical markers, such as CK7 and GATA3, this can lead to a potential diagnostic pitfall. We stained a cohort of triple-negative breast cancer with UPII. Compared with the diffuse, cytoplasmic staining in urothelial carcinoma, UPII was positive in 38.9% of apocrine carcinoma (7/18) with a course, granular cytoplasmic staining pattern and negative in all nonapocrine triple-negative breast cancer cases. Furthermore, the same staining pattern was present in all apocrine metaplasia of the breast (4/4) and apocrine sweat glands in normal skin (6/6). This distinct subcellular localization of UPII staining in breast carcinoma can offer a potential solution to the above diagnostic pitfall.

Triple-Negative Apocrine Breast Carcinoma Has Better Prognosis despite Poor Response to Neoadjuvant Chemotherapy.

Apocrine carcinoma is a rare subtype of invasive ductal breast cancer that shows apocrine differentiation and largely triple-negative immunohistology. Triple-negative breast cancers are known to have more aggressive clinical courses. However, unlike most other subtypes, it is reported that triple-negative apocrine carcinoma (TNAC) has a better prognosis. Due to the scarcity of reported studies, our knowledge regarding its clinical behavior, prognosis and response to therapy is very limited. In this study, we retrospectively retrieved 41 triple-negative apocrine carcinoma cases from our breast cancer database, with an average follow-up of 32.8 months. It was found that TNAC had a poorer response to neoadjuvant therapy but a better prognosis than other nonapocrine types of triple-negative breast cancer. Meanwhile, TNAC has a low proliferative nature, as indicated by its low Ki-67 index. An updated analysis of the Surveillance, Epidemiology, and End Results database showed that chemotherapy did not improve breast-cancer-specific survival in TNAC patients. Our results suggest that TNAC is a special subtype of triple-negative breast cancer with a better short-term prognosis despite poor response to neoadjuvant chemotherapy.

Apocrine Carcinoma of Breast -Uncommon Variant of Breast Malignancy

Apocrine Carcinoma of Breast -Uncommon Variant of Breast Malignancy

Neoadjuvant targeted therapy for apocrine carcinoma of the breast: A case report

BACKGROUNDApocrine carcinoma of the breast is a special type of invasive ductal carcinoma of the breast that is rare in clinical practice. Neoadjuvant therapy, especially neoadjuvant targeted therapy, has rarely been reported for apocrine carcinoma of the breast.CASE SUMMARYA 63-year-old woman presented with apocrine carcinoma of the left breast underwent core needle biopsy. The patient was diagnosed with apocrine carcinoma by immunohistochemical staining and negative hormone status (estrogen receptor and progesterone receptor) but showed overexpression of human epidermal factor receptor 2 (HER-2). Moreover, positive expression of androgen receptor (approximately 60%) and gross cystic disease fluid protein 15 was observed. The patient was treated with neoadjuvant targeted therapy consisting of the TCH regimen (docetaxel, carboplatin area under curve 6 and trastuzumab) every 21 d. The mass in the left breast was significantly reduced, and pain in the breast and left upper arm also improved.CONCLUSIONHER-2 positive apocrine carcinoma of the breast can be improved by neoadjuvant chemotherapy combined with targeted therapy.

Apocrine Carcinoma of Breast in a Male Patient: Case Report

Introduction: Apocrine carcinoma of breast is a rare type of malignant tumor, the incidence of which varies between 0.3 - 0.4 % of all female breast cancers.Apocrine carcinoma is exceptional in male patients and very few cases have been described in literature. This tumor shows distinct microscopic and immunohistological features. We report an exceptional observation of apocrine carcinoma of breast in a man. Patient and observation: He’s a 54 years old man who had for 2months a painless nodule at the left axillary..The patient had family history of breast and prostate cancers. Physical examination revealed a left axilary lymphadenopathy movable relative to superficial and deep plans with no evidence mass of breasts. MRI of the breast was performed and revealed a mass that was 38 x 10 mm in size.A biopsy of the lymphadenopathy was performed. It objectified a carcinomatous proliferation. An immunohistochemical study showed that tumor cells express Her 2, but do not express estrogenic and progesterone receptors. A tumorectomy of the left breast was performed and didn’t show any malignant lesion of the breast. The axiler dissection of 13 lymphnodes showed 11 metastatics ones with 3 breaking capsular. The diagnosis of apocrine carcinoma of the breast was made in despite of the result of the tumorectomy. The CT did not indicate metastasis. The patient was administered adjuvant chemotherapy then he received radiation therapy on left susclavicular, axila and breast with a total dose of 42Gy,15 fractions of 2.8 Gy on 21 days with no late effects. 1 year of trastuzumab was administrated. There was no recurrence or metastasis approximately 2 years after radiation therapy. Then the patient presented a susclavicular lymphnode that was comfirmed on the pet-scanner with multiple mediastinal lymphnodes. A biopsy of the susclavicular lymphnode comfirmed the progression of the disease. The patient started chemotherapy in association with pertuzumab and trastuzumab. Discussion: Apocrine carcinoma of the breast is a rare malignant tumor whose incidence varies between 0.3% and 4% of all female’s breast cancer and represents 0.5 % of all invasive breast cancers. This tumor is exceptional in men. Indeed, only a dozen cases have been described in the literature . Most neoplasms are slowly progressive, small in size, and are most frequently seen in the axilla. They can be recurrent and metastasize to the lymph node, lung, and bone. Male patients have been advanced disease at presentation compared to women which may be due to lack of public awareness of breast cancer in male. Histologically, it has glandular structures with apocrine features and decapitation secretions. There is cytoplasmic PAS positivity of the tumor cells. The presence of neoplastic glands high in the dermis and immediate subepidermis favors the primary origin of tumor cells from apocrine sweat glands. Apocrine adenocarcinomas are positive for cytokeratins, carcinoembryogenic antigen (CEA) and epithelial membrane antigen (EMA) . Usually, these tumors do not express the estrogen receptor-alpha, progesterone receptors and bcl-2. Apocrine adenocarcinoma has poor prognosis and the prognostic factors include size, histological type, lymph node involvement, and distant metastasis. The 10-year disease free survival rate in the absence of metastasis to the lymph nodes is 56%. Treatment protocols of apocrine carcinoma are similar to non apocrine carcinoma of breast. However studies involving the use of anti androgens are in progress. The treatment of choice is wide local excision with clear margins, with or without regional lymph node dissection. The role of radiation therapy also remains uncertain in the absence of clinical trials. No clear correlation between treatment modality and recurrence in apocrine carcinoma was apparent, and survival rates of apocrine carcinoma were not different from other breast carcinomas. Conclusion: In conclusion, male apocrine carcinoma is a very rare, unique and morphologically-distinctive, invasive ductal carcinoma.. Although immunohistochemical staining might show differences in males, the prognosis is not different from other breast carcinomas. It has different hormonal profile, androgen receptor positivity makes patient with apocrine carcinoma eligible for targeted therapy.

Comparative Study of Clinicopathologic Features of Apocrine Carcinoma of Breast with Invasive Breast Carcinoma of No Special Type- A Tertiary Care Centre Experience

Introduction: Apocrine Carcinoma (AC) of breast is a rare breast cancer comprising only 0.3-1.0% of all breast cancers. Microscopically, Invasive Duct Carcinoma of No Special Type (IDC-NST) and AC have similar architecture, but they differ in cell morphology. Immunohistochemistry for both the tumour types is also different. Aim: This study was undertaken to know the incidence of AC and analyse them with respect to different clinicopathological features and compare them with that of IDC-NST. Materials and Methods: This was an observational study conducted in Department of Pathology, Veer Surendra Sai Institute of Medical Science and Research, Burla from March 2010 to February 2019. Patients diagnosed as invasive breast carcinoma were taken as study group. Breast cancer in male patients and female patients taking neoadjuvant chemotherapy were excluded from study group. Clinical features, pathological features and immunohistochemical findings of IDC-NST and AC were studied and statistical data were analysed by SPSS version 23.0 for windows. Comparison of data was done by using Pearson’s Chi-square test. Results having p-value <0.05 were accepted as significant. Results: During the 10 years, 05 cases of AC and 560 cases of IDC-NST were found. Mean age of presentation of AC was 59.5 years and that of IDC-NST was 50.4 years. Most cases of AC and IDC-NST presented with breast lump of size >5 cm. Low grade (grade 1) carcinoma was seen in 20% of AC. Immunohistochemistry showed 3 (60%) cases of AC as triple negative, whereas 213 (38.2%) of IDC-NST were triple negative. All the cases of AC were Gross Cystic Disease Fluid Protein (GCDFP-15) and CK-7 positive. Conclusion: AC is a rare category of breast cancer. Although prognosis of AC and IDC are almost similar, correct diagnosis of AC is important as antiandrogenic therapy can be given to Androgen Receptor (AR) positive AC cases.

High Ki-67 expression is a marker of poor survival in apocrine breast carcinoma.

Apocrine carcinoma is avery rare type ofbreast cancer, which represents 0.5-4% ofall breast cancers. Theaim ofthestudy was to analyze biological and clinical features ofapocrine carcinoma and their influence on patients survival. The studied group consists of57 patients, who underwent treatment between 1987 and 2010. Expression ofER, PgR, HER2, AR, GCDFP-15, EGFR, CK 5/6, CK 8/18 and Ki-67 was assessed immunohistochemically on formalin-fixed paraffin-embedded tissue sections. Presence ofemboli and extent oflymphocyte infiltration were assessed on haematoxylin-eosin-stained slides. In the investigated group, 16 cases were ER/PgR positive and 49 were AR-positive. ER/PgR-negative tumours were often characterised by CK5/6 and EGFR positivity. The presence ofAR was related to HER-2 and GCDFP-15 expression and tumours with expression ofCK5/6 were more likely be EGFR positive and had higher Ki-67 LI. Higher probability of10-years OS and DFS was observed in patients with tumours characterized by Ki-67 LI<20% (p=0.036 and p=0.009, respectively). Favourable trend in OS was noted for patients with smaller tumours (p=0.053), without lymph node metastases (p=0.074) and without EGFR expression (p=0.060). In apocrine breast carcinoma expression ofKi-67 is one ofthemost important factors influencing patients' survival.

Apocrine breast carcinoma as an extremely rare breast cancer subtype – histopathological characteristics

Apocrine carcinoma (AC) is a distinctive and rare type of malignancy, counted for 0.3–4% of all breast cancer cases. It does not have a particular clinical or radiological features, although it is characterized by the apocrine morphology, estrogen receptor-negative and androgen receptor-positive profile. In the present study, among 1122 patients with breast cancer only 5 of them were diagnosed with apocrine carcinoma (0.4%). All patients were above 50 years old (51–63, mean: 57). Tumor size varied from 1.4 cm to 3.8 cm with a mean size of 2.4 cm, while mean size of all 1122 studied cases counted for 1.9 cm. Two tumors were classified as high-grade (G3), 2 as G2, and 1 as G1. Four tumors out of 5 did not affect lymph nodes (pN0 stage), whereas 1 was classified as pN2 with 9/19 regional lymph nodes affected. This observation was consistent with the whole studied group, in which pN0 stage made up the largest percentage. Presented results suggest that AC is less frequent in premenopausal patients. AC tends to present as invasive malignancy without nodal involvement and is usually characterized by relatively less aggressive biological behavior compared to other histological types of breast cancer. Due to the fact that AC is definitely a rare type of breast cancer, modern medicine has still limited treatment options to offer. Further research needs to be conducted in order to develop target therapies for this carcinoma.

All Benign and Malignant Apocrine Breast Lesions Over-Express Claudin 1 and 3 and Are Negative for Claudin 4

Invasive apocrine carcinoma of the breast is an uncommon triple negative tumour that lacks a specific therapeutic target. Apocrine metaplasia of the breast shares common morphological features with apocrine carcinoma, and was previously found to consistently over-express claudin 1 and to lack claudin 4. This study was aimed at finding whether apocrine carcinoma, and other related apocrine breast lesions, have similar claudin profile. The immunohistochemical expression of claudin 1, 3 and 4 was studied in 11 cases of in situ and invasive apocrine breast carcinoma, 7 benign apocrine lesions and 45 consecutive morphologically non-apocrine triple negative breast carcinomas. All cases were also immunostained for Gross Cystic Disease Fluid Protein-15 (GCDFP-15), a marker for apocrine differentiation. Apocrine breast lesions maintained their expression pattern from benign through DCIS to invasive carcinoma; all showing strong expression of claudin 1 and 3 and absence of claudin 4. The same pattern of expression was seen in 2 out of the 45 morphologically non-apocrine tumours, but both showed strong positive staining for GCDFP-15. It is concluded that all benign and malignant apocrine lesions of the breast have a consistent pattern of claudin 1, 3 and 4 expression, suggesting the presence of a specific pathway for the development of invasive apocrine carcinoma. The over-expression of claudin 1 and 3 may have therapeutic implications as targets for managing apocrine cancers.

Diagnostic impact of 18F-FDG PET/CT on the management of rare breast carcinomas: apocrine and neuroendocrine carcinomas

ObjectiveWe aimed to evaluate the diagnostic impact of 18F-FDG PET/CT in staging apocrine breast carcinoma (ABC) and primary breast neuroendocrine carcinoma (PBNEC) and to demonstrate possible alterations of the 18F-FDG uptake in these histopathologic subtypes. In addition, we aimed to compare 18F-FDG PET/CT findings between ABC, PBNEC and invasive ductal carcinoma (IDC). Material and methodsA total of 570 patients and 585 breast lesions were retrospectively included in this study. After patients were classified into molecular subtypes according to the histopathological analysis, 18F-FDG PET/CT imaging was performed. The SUVmax findings of primary tumors obtained from 18F-FDG PET/CT were compared between the groups. ResultsIDC was the most prevalent breast carcinoma (77.7%, n=446), with a low proportion of ABC (4.1%, n=24) and PBNEC (2.4%; n=14) diagnosed. The highest mean SUVmax was calculated in HER2 subtype of ABC and 18F-FDG uptake ratio in HER2 and TN subtypes were found statistically higher than Luminal B type of ABC (p=0.038 and p=0.019, respectively). Although 18F-FDG uptake in Luminal B subtype of PBNEC was higher than Luminal A subtype, difference was not statistically significant. Additionally, the axillary metastasis rate was significantly higher in the ABC group (p=0.015). ConclusionsThe histopathological ABC subtype group showed different 18F-FDG uptake than the IDC group. Even if 18F-FDG uptake was lower in the PBNEC group than in the other groups, PET/CT showed and adequate performance in detecting primary tumors and metastases. The 18F-FDG PET/CT scan results may contribute to the initial staging and management of ABC and PBNEC patients.

Rare case of breast apocrine carcinoma in men: diagnostic difficulties and contribution of HER 2

Background: Breast apocrine carcinoma in men is an exceptional form of breast carcinoma. This tumor is frequently characterized by overexpression of HER2 oncoprotein. Our case is very rare and posed diagnostic difficulties. Case presentation: We report an exceptional case of breast apocrine carcinoma in a 53 years old man, diagnosed after axillary biopsy followed by axillary lymph node dissection and left mastectomy. The patient received additional chemotherapy and radiotherapy. Conclusion: The oncoprotein HER 2 allowed us to retain the diagnosis of apocrine carcinoma of mammary origin in our patient after discussion of the case in multidisciplinary consultation meeting.

Histologic heterogeneity of triple negative breast cancer: A National Cancer Centre Database analysis

BackgroundTriple negative breast cancer (TNBC) is an aggressive disease, but recent studies have identified heterogeneity in patient outcomes. However, the utility of histologic subtyping in TNBC has not yet been well-characterised. This study utilises data from the National Cancer Center Database (NCDB) to complete the largest series to date investigating the prognostic importance of histology within TNBC. MethodsA total of 729,920 patients (pts) with invasive ductal carcinoma (IDC), metaplastic breast carcinoma (MBC), medullary breast carcinoma (MedBC), adenoid cystic carcinoma (ACC), invasive lobular carcinoma (ILC) or apocrine breast carcinoma (ABC) treated between 2004 and 2012 were identified in the NCDB. Of these, 89,222 pts with TNBC that received surgery were analysed. Kaplan–Meier analysis, log-rank testing and multivariate Cox proportional hazards regression were utilised with overall survival (OS) as the primary outcome. ResultsMBC (74.1%), MedBC (60.6%), ACC (75.7%), ABC (50.1%) and ILC (1.8%) had significantly different proportions of triple negativity when compared to IDC (14.0%, p < 0.001). TNBC predicted an inferior OS in IDC (p < 0.001) and ILC (p < 0.001). Lumpectomy and radiation (RT) were more common in MedBC (51.7%) and ACC (51.5%) and less common in MBC (33.1%) and ILC (25.4%), when compared to IDC (42.5%, p < 0.001). TNBC patients with MBC (HR 1.39, p < 0.001), MedBC (HR 0.42, p < 0.001) and ACC (HR 0.32, p = 0.003) differed significantly in OS when compared to IDC. Conclusion(s)Our results indicate that histologic heterogeneity in TNBC significantly informs patient outcomes and thus, has the potential to aid in the development of optimum personalised treatments.

Pure Apocrine Carcinomas Represent a Clinicopathologically Distinct Androgen Receptor-Positive Subset of Triple-Negative Breast Cancers.

Apocrine carcinomas comprise ∼1% of all breast cancers and are characterized by large cells bearing abundant eosinophilic granular cytoplasm, round nuclei, and prominent nucleoli. They are typically estrogen receptor/progesterone receptor/HER2 negative, making them unresponsive to typical hormonal or HER2-based chemotherapy. However, this subtype of triple-negative breast cancers expresses androgen receptor (AR), a feature not shared by most nonapocrine triple-negative cancers (NA-TNCs). AR therefore represents a potential diagnostic tool and therapeutic target for apocrine breast carcinoma. All pure apocrine carcinomas diagnosed during a 10-year period were reviewed, and clinicopathologic characteristics were compared with a control group of 26 NA-TNC cases. Twenty apocrine carcinomas were identified (∼0.8% of all breast cancers). The mean age at diagnosis was 69.3 years for apocrine carcinomas and 56.7 years for NA-TNC. All apocrine carcinomas and no NA-TNC were AR positive. The proportions of apocrine carcinoma grades varied, with G1 being seen in 15% of patients, G2 in 55%, and G3 in 30%. In contrast, 100% of NA-TNC cases were G3. The majority of apocrine carcinomas presented at low T stage (T1: 70%; T2: 20%; T3: 10%; T4: 0%), whereas NA-TNC cases more often presented at T2 or higher (T1: 46.2%; T2: 30.8%; T3: 11.5%; T4: 11.5%). Thirty percent of apocrine carcinomas and 30.8% of NA-TNCs had nodal metastases at presentation. Apocrine carcinomas had a favorable clinical prognosis, with 80% of patients showing no evidence of disease-related morbidity or mortality (mean follow-up: 45.2 mo). Pure apocrine carcinomas represent a clinicopathologically distinct subgroup of triple-negative breast cancer characterized by AR positivity. When compared with NA-TNC, apocrine carcinomas more often present in older women with lower grade and T stage, a group in which a more conservative treatment regimen is often desired.

Meme Apokrin Karsinomu

Meme Apokrin Karsinomu

Clinicopathologic features and prognostic significance of breast apocrine carcinoma

Clinicopathologic features and prognostic significance of breast apocrine carcinoma

Apocrine Carcinoma of Breast: A Rare Case Report

Apocrine Carcinoma of Breast: A Rare Case Report