APOCRINE CARCINOMA VS APOCRINE METAPLASIA WITH ATYPIA OF THE BREAST -USE OF ASPIRATION BIOPSY CYTOLOGY

OBJECTIVE: To solve the problem of diagnosing apocrine carcinoma (APCA ) through distinguishing it frombenign apocrine metaplasia with atypia (APMA). STUDY DESIGN: The study group consisted of five histologicall y confirmed cases of uncommon infiltrating apocrine carcinoma and it c ase of noninfiltrating apocrine carcinoma of the breast by aspiration biopsy cytology. The control group consisted of 103 cases of benign ap ocrine metaplasia with no atypia (APMN), 4 cases of APMA and 34 cases of common-type adenocarcinoma that were encountered in 662 breast aspi rations from 1988 to 1992 at Hekinan Municipal Hospital. RESULTS: In A PCA the average age of patients (65+/-17.7 SD) (mean +/-SD) teas move than 20 years older than APMA, and APCA generally measured greater tha n or equal to 2 cm or more in diameter as compared to greater than or equal to 2 cm in APA IA lesions. In APCA the apocrine cells had high c ellularity, with the cells occur singly and with syncytia in the backg round. Numerous degenerated apocrine cells and characteristic cell det ritus were found. APCA was also characterized by apocrine cells with m ore marked nuclear abnormalities, including hyperchromasia and irregul ar nuclear shape, frequently with irregular nucleoli; more nuclei meas ure greater than or equal to 12 mu m in diameter than in APMA. These f indings, however, were present only to a mild degree in APMA, if at al l. APMA may coexist with APCA.