Breast malignant
In situ carcinoma
Apocrine DCIS


Topic Completed: 1 January 2012

Revised: 28 October 2019

Copyright: 2002-2019, PathologyOutlines.com, Inc.

PubMed Search: Apocrine [title] breast

Dina Kandil, M.D.
Page views in 2018: 2,842
Page views in 2019 to date: 3,038
Cite this page: Kandil D. Apocrine DCIS. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/breastmalignantapocrineDCIS.html. Accessed November 19th, 2019.
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
Back to top