Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota 55905-0001, USA.
Arch Pathol Lab Med. 2012 Feb;136(2):179-82. doi: 10.5858/arpa.2011-0225-OA.
Atypical apocrine adenosis is a rare breast lesion in which the cellular population demonstrates cytologic alterations that may be confused with malignancy. The clinical significance and management of atypical apocrine adenosis are unclear because of the lack of long-term follow-up studies.
To determine the breast cancer risk in a retrospective series of patients with atypical apocrine adenosis diagnosed in otherwise benign, breast excisional biopsies.
We identified 37 atypical apocrine adenosis cases in the Mayo Benign Breast Disease Cohort (9340 women) between 1967 and 1991 with a blinded pathology rereview. Breast cancer diagnoses subsequent to initial atypical apocrine adenosis biopsy were identified (average follow-up, 14 years).
The mean age at diagnosis of atypical apocrine adenosis in the group was 59 years. Breast carcinoma subsequently developed in 3 women (8%) with atypical apocrine adenosis, diagnosed after follow-up intervals of 4, 12, and 18 years. The tumor from 1 of the 3 cases (33%) was ductal carcinoma in situ, contralateral to the original biopsy, and the other 2 cases (66%) were invasive carcinoma. Ages at the time of diagnosis of atypical apocrine adenosis were 55, 47, and 63 years for those that developed in situ or invasive carcinoma.
(1) Atypical apocrine adenosis was a rare lesion during the accrual era of our cohort (<1% of cases); (2) women found to have atypical apocrine adenosis were, on average, older than were other patients with benign breast disease, however, there does not seem to be an association with age and risk for developing carcinoma in patients diagnosed with atypical apocrine adenosis, as previously suggested; and (3) atypical apocrine adenosis does not appear to be an aggressive lesion and should not be regarded as a direct histologic precursor to breast carcinoma.
非典型大汗腺腺瘤是一种罕见的乳腺病变，其中细胞群体表现出可能与恶性肿瘤混淆的细胞学改变。由于缺乏长期随访研究，非典型大汗腺腺瘤的临床意义和处理方法尚不清楚。
在回顾性系列研究中，确定诊断为非典型大汗腺腺瘤的患者在良性乳腺切除活检中的乳腺癌风险。
我们在 1967 年至 1991 年期间在梅奥良性乳腺疾病队列（9340 名女性）中确定了 37 例非典型大汗腺腺瘤病例，并进行了盲法病理复查。确定了初始非典型大汗腺腺瘤活检后发生的乳腺癌诊断（平均随访时间为 14 年）。
该组中诊断为非典型大汗腺腺瘤的患者平均年龄为 59 岁。在随访间隔为 4、12 和 18 年后，有 3 例（8%）患者发展为非典型大汗腺腺瘤的乳腺癌。3 例中有 1 例（33%）为原位导管癌，与原始活检对侧，另外 2 例（66%）为浸润性癌。诊断为非典型大汗腺腺瘤时的年龄分别为诊断为原位癌或浸润性癌的患者的 55、47 和 63 岁。
（1）非典型大汗腺腺瘤是我们队列的累积时代（<1%的病例）罕见病变；（2）诊断为非典型大汗腺腺瘤的女性平均年龄大于其他患有良性乳腺疾病的患者，但与之前的建议相反，在诊断为非典型大汗腺腺瘤的患者中，似乎没有与年龄和发生癌的风险之间的关联；（3）非典型大汗腺腺瘤似乎不是一种侵袭性病变，不应该被视为乳腺癌的直接组织学前体。
