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Abstract
The apocrine type of encapsulated papillary carcinoma (ECP-A), of the breast is a rare neoplasm and there are only eight cases reported to date. Herein, we report the ninth case. A 68-year-old Japanese woman presented with a left breast mass. The cytoplasm of the tumour cells showed positive immunostaining for GCDFP-15. Myoepithelial cells were absent within the papillary structures and at the periphery of the lesion. The clinical course of the patient was uneventful 11 months after surgery. We postulate that EPC-A belongs to the molecular apocrine type of breast carcinoma.
Keywords: encapsulated papillary carcinoma, breast, apocrine.
INTRODUCTION
The disease entity of encapsulated papillary carcinoma (EPC) of the breast, previously termed intracystic papillary carcinoma, has been integrated into the recent World Health Organization classification.1 The common type of EPC is a luminal breast cancer. There are only eight cases of the apocrine variant of EPC (EPC-A) reported to date.2-4 In this article we present the ninth case and discuss the clinical and pathological significance of this subtype.
CASE REPORT
A 68-year-old Japanese woman presented to the Department of Surgery, Kochi Red Cross Hospital complaining of a mass in the left breast. Fine needle aspiration cytology obtained from the left lump showed indeterminate findings. The subsequent mammotome biopsy showed a malignant neoplasm and left partial mastectomy with sentinel lymphadenectomy was performed. The specimen was fixed in 10% buffered formalin for 8 hours and processed in an automated histology processor ( LEICA , ASP 2005 ) according to standard laboratory protocol.
Histological sections were cut from the paraffin-embedded tissue blocks and stained with hematoxylin and eosin. In addition, immunostains were performed using the Ventana Benchmark XT autostainer (Ventana Medical Systems, Tucson, AZ). The primary antibodies employed included GCDFP-15 (23A3, 1:40, Novocastra Laboratories, Ltd, Newcastle, UK), ER (1D5, 1:2, DAKO, Glostrup, Denmark), PgR (PgR636, prediluted, DAKO, Glostrup, Denmark), androgen receptor (AR27, 1:100, Novocatra Laboratories, Ltd, Newcastle, UK), alpha smooth muscle actin (A14, 1:800, DAKO, Glostrup, Denmark), cytokeratin 14 (LL002, 1:20, Novocastra Laboratories, Ltd, Newcastle, UK), p63 (4A4, 1:800, Lab Vision, CA, USA), CD10 (56C6, prediluted, Novocastra Laboratories, Ltd, Newcastle, UK), S-100 protein (polyclonal, 1:2400, DAKO, Gostrup, Denmark) and calponin (CAlP, 1:100, DAKO, Glostrup, Denmark). HER2 gene status was determined by FISH analysis using the Vysis...