Breast malignant, males, children
In situ carcinoma
Apocrine DCIS

Author: Dina Kandil, M.D. (see Authors page)

Revised: 27 September 2018, last major update January 2012

Copyright: (c) 2002-2018,, Inc.

PubMed Search: Apocrine [title] breast

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Cite this page: Kandil, D. Apocrine DCIS. website. Accessed January 18th, 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

Images hosted on PathOut server:

Courtesy of Mark R. Wick, M.D.

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

Micropapillary pattern

Cribriform pattern

Images hosted on Flickr:

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

Images hosted on other servers:

Threefold variation in nuclear size

Low and high power

Abundant granular eosinophilic cytoplasm

Androgen receptor

Various images

p53 (Figure 7)

Virtual slides

Images hosted on other servers:

High grade apocrine DCIS

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