Apocrine Encapsulated Papillary Carcinoma of the Breast: The First Reported Case with an Infiltrative Component

Kővári, Bence; Ormándi, Katalin; Simonka, Zsolt; Vörös, András

doi:10.4048/jbc.2018.21.2.227

Cited by 12 publications

(12 citation statements)

References 13 publications

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“…The 4 th and 5 th editions discuss these tumors under the heading of “ Carcinomas with apocrine differentiation ”, recognizing that several histological types may show apocrine morphology and immunophenotype: those listed beside IBC-NST include invasive micropapillary , lobular and mucinous carcinomas . Furthermore, encapsulated papillary carcinoma of apocrine differentiation has also been reported 45 , 46 . The 5 th edition defines apocrine differentiation by light microscopic morphology as cells with distinct cell borders, abundant granular eosinophilic or vacuolated cytoplasm, large round to oval nuclei and prominent nucleoli and a GCDFP-15+, ER- PR- AR+ immunophenotype 5 .…”

Section: The Classificationsmentioning

confidence: 97%

Histological type and typing of breast carcinomas and the WHO classification changes over time

Cserni

2020

Pathologica

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Summary The World Health Organization’s new classification of breast tumors has just been published. This review aims to examine the morphological categorization of breast carcinomas which is still principally based on histological features and follows the traditions of histological typing. It gives a subjective and critical view on the WHO classifications and their changes over time, and describes the changes related to some of the most common or challenging breast carcinomas: in situ carcinomas, invasive breast carcinomas of no special type, lobular, cribriform, tubular, mucinous, papillary, metaplastic carcinomas and carcinomas with medullary pattern and those with apocrine differentiation are discussed in more details. Although the 5 th edition of the classification is not perfect, it has advantages which are mentioned along with problematic issues of classifications.

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Section: The Classificationsmentioning

confidence: 97%

Histological type and typing of breast carcinomas and the WHO classification changes over time

Cserni

2020

Pathologica

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“…Further single case studies have observed similar morphological and IHC findings including AR positivity. Kovari et al recently reported the first case of apocrine EPC with accompanying invasive carcinoma, also showing apocrine morphology [40]. Where clinical follow-up is available, all patients with reported apocrine EPC remain well with no evidence of recurrence.…”

Section: Encapsulated Apocrine Papillary Carcinomamentioning

confidence: 98%

Apocrine lesions of the breast

2021

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Apocrine change is recognised in benign, atypical and malignant lesions of the breast. Apocrine metaplasia, a frequent finding in the breast of women over the age of 25 years, is most commonly seen in benign cysts with a simple or papillary configuration. Apocrine change is also recognised in other benign lesions including sclerosing adenosis, now known as apocrine adenosis. Apocrine atypia usually refers to cytological atypia in which there is at least threefold variation in nuclear size but architectural atypia may also occur. The distinction between atypical apocrine hyperplasia and non-high-grade apocrine ductal carcinoma in situ may be difficult due to the relative rarity of these entities and the lack of validated diagnostic criteria. Lobular carcinoma in situ (LCIS) with apocrine change is considered to be a variant of pleomorphic LCIS. An apocrine variant of encapsulated papillary carcinoma is also recognised. Apocrine change is described in invasive carcinoma, including no special type, lobular, micropapillary and mucinous variants. The recent WHO 2019 update recognises ‘carcinoma with apocrine differentiation’ as a special type breast carcinoma based on the presence of apocrine morphology in at least 90% of the tumour. Tumours with apocrine morphology are usually but not always hormone receptor negative. Human epidermal growth factor receptor 2 (HER-2) status is variable. Molecular studies have identified breast tumours with apocrine features and high expression of androgen receptor mRNA including ‘luminal androgen receptor tumours’ and ‘molecular apocrine tumours’. The term ‘pure apocrine carcinoma’ has been proposed to describe an invasive carcinoma with apocrine morphology that is oestrogen and progesterone receptor negative and androgen receptor positive. HER-2 status may be positive or negative. This article reviews the pathology of benign, atypical and malignant apocrine lesions of the breast, with emphasis on diagnostic criteria including an approach to evaluation of apocrine lesions on needle core biopsy, and recent advances in our understanding of invasive apocrine carcinoma.

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“…8 In the previous case report of the apocrine encapsulated papillary carcinoma with frank invasion, the biopsy specimen contained an invasive component. 8 Meanwhile, in our case, the biopsy specimen showed the same findings of the encapsulated papillary carcinoma component but without definitive invasion. Biopsy sites should be carefully determined using imaging findings because the location of the biopsy needle greatly influences diagnosis in such cases.…”

Section: Discussionmentioning

confidence: 97%

“…1,10,11 On the other hand, a previous report showed that patients with apocrine encapsulated papillary carcinoma without invasion survived without recurrence even when they were not treated with systemic therapy. 5,8…”

Section: Discussionmentioning

confidence: 99%

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A Case Report on Apocrine Encapsulated Papillary Carcinoma of the Breast with Frank Invasion: A Diagnostic Quandary

et al. 2022

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Encapsulated papillary carcinoma is a special type of breast cancer defined in the fifth edition of the World Health Organization breast tumor classification guidelines. Apocrine encapsulated papillary carcinoma is extremely rare, and only 10 cases have been described previously. We encountered a case of apocrine encapsulated papillary carcinoma with frank invasion. The patient was a 77-year-old woman with a painless mass in her right breast. Core needle biopsy revealed that the tumor cells had voluminous eosinophilic cytoplasm and enlarged nuclei with prominent nucleoli. We diagnosed this lesion as carcinoma with apocrine differentiation and suggested the possibility of an encapsulated papillary carcinoma. The patient underwent a right-sided mastectomy. Gross examination of the resected specimen revealed a multilobulated tumor. Microscopically, the tumor cells, which had voluminous eosinophilic cytoplasm and enlarged nuclei with prominent nucleoli, proliferated in papillary fashion with fibrous stalks in the cystic space. Myoepithelial cells were not observed around the cystic space. Frank invasion was also observed around the encapsulated papillary carcinoma. Immunohistochemistry analysis revealed that the tumor cells were negative for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 and positive for androgen receptor and gross cystic disease fluid protein 15. Based on these findings, we diagnosed this lesion as an apocrine encapsulated papillary carcinoma with frank invasion.

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Apocrine Encapsulated Papillary Carcinoma of the Breast: The First Reported Case with an Infiltrative Component

Cited by 12 publications

References 13 publications

Histological type and typing of breast carcinomas and the WHO classification changes over time

Histological type and typing of breast carcinomas and the WHO classification changes over time

Apocrine lesions of the breast

A Case Report on Apocrine Encapsulated Papillary Carcinoma of the Breast with Frank Invasion: A Diagnostic Quandary

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