Breast malignant
In situ carcinoma
Apocrine DCIS

Topic Completed: 1 January 2012

Minor changes: 25 June 2020

Copyright: 2002-2019,, Inc.

PubMed Search: Apocrine [title] breast

Dina Kandil, M.D.
Page views in 2020 to date: 40
Cite this page: Kandil D. OLD Apocrine. website. Accessed August 7th, 2020.
Definition / general
  • DCIS with cells containing abundant eosinophilic cytoplasm, vesicular nuclei and prominent nucleoli
  • Uncommon variant; clinical behavior similar to classic DCIS
Microscopic (histologic) description
  • Growth pattern may be solid, cribriform or micropapillary
  • Tumor grade is based on nuclear features and presence of comedo-type necrosis (Hum Pathol 2001;32:487)
  • Nuclei are graded 1 - 3 based on nuclear size, pleomorphism and nucleoli
  • Nuclear size (compared to benign apocrine cells) is either small (1 - 2x), intermediate (3 - 4x) or large (5x or larger)
  • Grade 1 nuclei: low pleomorphism, small / intermediate size, usually single prominent nucleolus
  • Grade 2 nuclei: moderate pleomorphism, small/intermediate size, multiple nucleoli; may have occasional large nuclei or multinucleated cells
  • Grade 3 nuclei: intermediate / large size, marked pleomorphism, coarse chromatin, irregular nuclear contour, frequently multiple nucleoli
  • Necrosis: punctuate or comedo necrosis
  • Low grade: nuclear grade 1 or 2 without necrosis
  • High grade: tumors with grade 3 nuclei and necrosis; similar to high grade nonapocrine DCIS, but with cytoplasmic apocrine features and 10%+ nuclei with single large nucleolus and vesicular chromatin
  • Intermediate grade: cases not classified as low or high histologic grade
Microscopic (histologic) images

AFIP images

Cells have abundant cytoplasm, vesicular nuclei and prominent nucleoli (AFIP)

Micropapillary pattern

Cribriform pattern

Contributed by Dr. Mark R. Wick

Images hosted on other servers:

Threefold variation in nuclear size

Low and high power

Abundant granular eosinophilic cytoplasm

Androgen receptor

Various images

51 year old woman with apocrine DCIS in adenosis with Paget's disease of the breast, courtesy of Dr. Semir Vranic (Bosnia)

Positive stains
Negative stains
Differential diagnosis
  • Atypical apocrine hyperplasia: difficult to distinguish from low grade apocrine DCIS; absence of fully developed architectural features of DCIS
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