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Apocrine Metaplasia
Etiology

Secondary to an irregular response by breast tissue to hormonal stimuli
Pathogenesis

May be due to relative or absolute excess of estrogen, decrease in progesterone, or abnormal response to either hormone by breast tissue,
Epidemiology

60-90% of breasts at autopsy
Reproductive age women
General Gross Description

"Blue-dome" cysts which may be quite large
Firm gray-white fibrous tissue •Examples:
General Microscopic Description

Cysts containing inspissated secretions which may calcify
Cysts may also contain macrophages; lined by flattened epithelium
Apocrine metaplasia with columnar epithelium containing small nuclei and brightly eosinophilic cytoplasm
•Examples:
Apocrine Metaplasia of Breast (Med Pow) Apocrine Metaplasia of Breast (Low Pow) Apocrine Metaplasia of Breast (High Power) Fibrocystic change (Low Power) Fibrocystic change with benign calcification
Clinical Correlation

About 10% of women have clinically evident disease
May be associated with tenderness and irregular nodularity which varies during the menstrual cycle
Microcalcifications may be demonstrable on mammogram
May be associated with epithelial hyperplasia or sclerosing adenosis although those entities should be reported separately
Cysts and fibrosis do not elevate risk for breast carcinoma
References

Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th edition. Philadelphia, W.B. Saunders, 1994, pp. 1093-4.

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Apocrine Metaplasia
Synopsis by: Melinda Sanders M.D. (T04000M74320)[302]
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