Other carcinoma subtypes, WHO classified

Topic Completed: 1 March 2012

Minor changes: 21 June 2020

Copyright: 2002-2019,, Inc.

PubMed search: Apocrine carcinoma [title] breast

Monika Roychowdhury, M.D.
Page views in 2019: 9,788
Page views in 2020 to date: 9,609
Cite this page: Roychowdhury M. Apocrine. website. Accessed November 25th, 2020.
Definition / general
  • > 90% of tumor cells have cytologic or immunohistochemical features of apocrine cells
  • Rare, 1% - 4% of all breast carcinomas
Prognostic factors
Case reports
  • 71 year old woman with apocrine adenocarcinoma of the nipple (Cases J 2008;1:88)
  • 84 year old woman had a total mastectomy with axillary dissection for a breast nodule (Case of the Week #68)
Gross description
Microscopic (histologic) description
  • Tumor cells have distinct cell margins, abundant acidophilic cytoplasm with eosinophilic granules, central to eccentric vesicular nuclei with prominent nucleoli
  • May have glandular differentiation with apocrine snouts and prominent nucloeoli
  • Limit diagnosis to tumors with widespread apocrine change and obvious malignancy
  • Type A cells: abundant granular and intensely eosinophilic cytoplasm, granules are PAS+ diastase resistant, nuclei vary from globoid with prominent nucleoli to hyperchromatic
  • Type B cells: abundant cytoplasm with fine empty vacuoles, creating a foamy appearance resembling histiocytes, nuclei are similar to type A cells
  • Exclude: cases with clear cells of any type in any amount; other subtypes including tubular, lobular, mucinous, invasive micropapillary or medullary
Microscopic (histologic) images
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Case of the Week #68


BCL2 negative

Contributed by Dr. Mark R. Wick

AFIP images

Solid growth

Histiocytoid variant with isolated
cells resembling histiocytes
in desmoplastic stroma,
resembles granular cell tumor

Case of the Week #68

Contributed by Dr. Semir Vranic


AR expression, 20x

Estrogen receptor, 20x

HER2, 20x

HER2 gene, CISH 2

Images hosted on other servers:

Abundant cytoplasm with distinct cell margins

Cytoplasm is granular, nuclei are round

Cells have abundant cytoplasm with distinct cell margins

Cytoplasm is granular, nuclei are round with prominent nucleoli

With apocrine DCIS

Missing Image

Cancerization of lobule



Positive stains
Negative stains
Electron microscopy description
  • Prominent mitochondria, some with abnormal cristae
  • Large membrane bound vesicles with dense homogenous osmophilic cores
Electron microscopy images

AFIP images

Smooth and rough
dense nucleoli

Cytokeratin fila-
ments (arrow), lipid
droplets, mito-
chondria, lysosomes

Cytoplasm contains numerous
lysosomes, lipid droplets,
dilated mitochondria and
vesicular endoplasmic reticulum

Images hosted on other servers:

Cytoplasm rich in organelles

Electron dense
granules, condensed, at
secretory pole of cell

Molecular / cytogenetics description
  • Form a distinct, even if heterogeneous, molecular subgroup of breast carcinomas that recapitulate the phenotype of apocrine sweat glands (Mol Oncol 2009;3:220)
  • Abnormalities at 7q (codes for GCDFP-15 and prolactin inducible protein)
  • Also loss of heterozygosity for p53 gene, VHL (3p25) gene, NB gene (1p35-36), PKD1/TSC2 gene at 16p13 (Mod Pathol 1999;12:1083)
Differential diagnosis
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