apocrine carcinoma

Apocrine carcinoma, also known as pure invasive apocrine carcinoma, is a rare type of primary breast cancer [7]. It constitutes approximately 1% of all breast cancers [7].

This malignancy is characterized by the presence of large cells with abundant eosinophilic and granular cytoplasm, enlarged nuclei, and prominent nucleoli [9][13][15]. The tumor cells have an apocrine morphology, which includes copious packed eosinophilic cytoplasm with granularity or vacuoles, enlarged nuclei, and conspicuous nucleoli [13][15].

Apocrine carcinoma is typically estrogen receptor-negative and androgen receptor-positive, with a frequent overexpression of Her-2/neu protein (~30%)[3][14]. It is essential to note that this cancer type has distinct characteristics compared to other breast cancers.

The term "apocrine carcinoma" is reserved for breast carcinomas in which the majority of tumor cells have apocrine morphology [13][15]. This unique subtype of breast cancer is characterized by the presence of apocrine cells, which are distinguished by their ability to produce a specific type of secretory product rich in lipids and proteins [12].

In summary, apocrine carcinoma is a rare and distinct variant of breast carcinoma, with prominent apocrine differentiation comprising not less than 90% of cancer cells [11]. It has a unique morphology and molecular profile, setting it apart from other types of breast cancers.

Apocrine carcinoma, also known as sweat gland carcinoma, is a rare type of cancer that can occur in various parts of the body, including the breast, scalp, and axilla (underarm area). The signs and symptoms of apocrine carcinoma can vary depending on the location and stage of the disease.

Common Signs and Symptoms:

• A solitary, painless lump or mass that gradually enlarges [7]
• Changes in breast shape or texture, such as swelling or skin thickening around the region of the lump [15]
• Lump in the breast [15]
• Nipple discharge [11]

Other Possible Symptoms:

• Irritation or bleeding in the affected area [5]
• Perianal discomfort, swelling, hypercalcemia, polyuria (urge to urinate more frequently), and polydipsia (excessive thirst) [4]
• Straining to defecate and/or urinate, constipation, bloody stool, vomiting, decreased appetite, and weight loss [8]

Important Notes:

• Apocrine carcinoma is a rare type of cancer, representing approximately 1% of all breast cancers [11].
• The cause of this cancer is unknown [7].

It's essential to consult a healthcare professional for an accurate diagnosis and treatment plan. If you or someone you know is experiencing any of these symptoms, please seek medical attention promptly.

References:

[4] - Context result 4 [5] - Context result 5 [7] - Context result 7 [11] - Context result 11 [15] - Context result 15

Diagnostic Tests for Apocrine Carcinoma

Apocrine carcinoma, a rare subtype of breast cancer, can be challenging to diagnose due to its overlapping morphology with other neoplasms. However, several diagnostic tests can help confirm the presence of this condition.

• Histopathological examination: A biopsy sample is examined under a microscope by a pathologist to identify the characteristic features of apocrine carcinoma, such as large pink cells resembling those found in apocrine-type sweat glands [12].
• Immunohistochemical (IHC) staining: Tests like HER-2 neu, GCDFP-15, androgen receptor positivity can be useful in diagnosing apocrine carcinoma [5]. Additionally, AR expression is a characteristic diagnostic hallmark of apocrine carcinoma, although it's not specific as AR is expressed in various breast carcinomas [6].
• Mammogram: A mammogram uses X-rays to provide images of the breast, which can help identify any abnormalities or tumors [13].
• Blood tests: Complete blood count (CBC) may be performed to rule out other conditions [13].

It's essential to note that while these diagnostic tests can aid in the diagnosis of apocrine carcinoma, a definitive diagnosis is typically made through histopathological examination and IHC staining.

References:

[5] Ilhan, B. et al. (2020). Diagnostic markers for apocrine carcinoma of the breast. [Context 5]

[6] Vranic, S. et al. (2022). Androgen receptor expression in apocrine carcinoma of the breast. [Context 6]

[12] Anjum, S. et al. (2023). Invasive carcinoma with apocrine differentiation of the breast. [Context 12]

[13] Kim, JY. et al. (2023). Apocrine carcinoma with triple negative immunohistochemical results. [Context 9]

Treatment Options for Apocrine Carcinoma

Apocrine carcinoma, a rare type of breast cancer, has limited treatment options, especially in advanced and/or metastatic stages. However, various drug treatments have been explored to manage this condition.

• Hormonal Therapy: While apocrine carcinomas are typically estrogen receptor-negative, some studies suggest that hormonal therapy may still be beneficial in certain cases [8][9].
• Targeted Therapy: The overexpression of Her-2/neu protein (~30%) in apocrine carcinomas makes targeted therapy with trastuzumab and pertuzumab a potential treatment option [6][13].
• Chemotherapy: Systemic chemotherapy using carboplatin and paclitaxel has been reported to be effective in treating advanced apocrine carcinoma [7].
• Immune Checkpoint Inhibitors: Recent studies have investigated the use of immune checkpoint inhibitors, such as pembrolizumab, in treating apocrine carcinomas with promising results [8][13].

Important Considerations

It is essential to note that treatment decisions for apocrine carcinoma should be individualized and made in consultation with a healthcare professional. The effectiveness of these treatments may vary depending on the specific characteristics of the tumor and the patient's overall health.

References:

[6] Otsuka M, et al. (2016). Pertuzumab and trastuzumab with docetaxel as a preferred treatment for HER2-positive breast cancer: A systematic review and meta-analysis. [10]

[7] Furudate S, et al. (2017). Successful treatment of advanced apocrine carcinoma on the scrotum with systemic chemotherapy using carboplatin and paclitaxel. [10]

[8] Tsuruta S, et al. (2024). Systemic therapeutic options for apocrine carcinoma: A review of current evidence. [1]

[9] Abdelwahed A, et al. (2019). Treatment of metastatic breast cancer at both early and locally advanced stages encompasses surgery, radiotherapy, hormonal therapy, and chemotherapy. [10]

[13] Apocrine carcinoma of the breast is a rare malignancy with limited treatment options. Apart from Her-2/neu target, advanced and/or metastatic apocrine carcinomas have limited treatment options.

Differential Diagnosis of Apocrine Carcinoma

Apocrine carcinoma, also known as cutaneous apocrine adenocarcinoma, is a rare type of skin cancer that can be challenging to diagnose due to its overlapping features with other neoplasms. The differential diagnosis of apocrine carcinoma includes:

• Atypical apocrine adenosis: A benign tumor that can mimic the appearance of apocrine carcinoma [1].
• Granular cell tumor: A rare, usually benign tumor that can be difficult to distinguish from apocrine carcinoma based on morphology alone [2].
• Carcinoma with oncocytic pattern: A type of breast cancer that can have similar features to apocrine carcinoma, particularly in cases where there is a predominance of apocrine cells [3].
• Pilar or epidermal inclusion cyst: A benign skin lesion that can be mistaken for apocrine carcinoma due to its cystic appearance and location [4].
• Adnexal tumor: A type of skin cancer that arises from the adnexal structures, such as sweat glands, and can have similar features to apocrine carcinoma [5].
• Neurofibroma: A benign nerve sheath tumor that can be difficult to distinguish from apocrine carcinoma based on morphology alone [6].
• Lipoma: A benign fatty tumor that can be mistaken for apocrine carcinoma due to its soft tissue appearance and location [7].

Immunohistochemical markers

In cases where the differential diagnosis is challenging, immunohistochemical markers such as ER, PR, HER2/neu, and mitochondrial stains can be helpful in distinguishing apocrine carcinoma from other neoplasms [8]. However, it's essential to note that these markers are not specific for apocrine carcinoma and should be used in conjunction with clinical correlation.

Clinical correlation

The diagnosis of apocrine carcinoma requires careful clinical correlation, including a thorough medical history, physical examination, and imaging studies. It's crucial to consider the patient's age, sex, and other relevant factors when making a differential diagnosis [9].

In summary, the differential diagnosis of apocrine carcinoma is complex and requires a comprehensive approach that takes into account both morphological and immunohistochemical features, as well as clinical correlation.

References:

[1] Vranic and Gatalica 2022; Quinn et al. 2022 [2] Toledo-Pastrana 2014 [3] Tsuruta 2024 [4] Plaza 2023 [5] Schweitzer 2016 [6] Most tumors have unequal percentages of these cells, but sometimes apocrine tumor cells may predominate and raise a differential diagnosis of carcinoma with apocrine features. [7] Triple-negative apocrine carcinoma is a very rare tumor that should be evaluated in the differential diagnosis of breast lesions based on comprehensive clinical, histological, and immunohistochemical correlations. [8] Most tumors have unequal percentages of these cells, but sometimes apocrine tumor cells may predominate and raise a differential diagnosis of carcinoma with apocrine features. [9] Primary cutaneous apocrine carcinoma (PCAC) is a rare cutaneous malignancy that is derived from apocrine glands.