紀要論文 乳腺アポクリン癌15例の臨床病理学的検討

北村, 美奈  ,  森, 毅  ,  梅田, 朋子  ,  河合, 由紀  ,  冨田, 香  ,  清水, 智治  ,  谷, 眞至

30 ( 1 )  , pp.85 - 89 , 2017-03-10 , 滋賀医科大学雑誌編集委員会
ISSN:0912-3016
内容記述
The clinicopathological features of apocrine carcinoma (AC) have not been fully characterized till date owing to its rare occurrence. We retrospectively reviewed data from 15 AC cases. Materials: Of 817 patients treated for primary breast carcinoma, we reviewed the data of 15 patients, who had been histologically diagnosed as AC. The expression of estrogen receptor (ER), progesterone receptor (PgR), and human epidermal growth factor receptor 2 (HER2) as well as Ki67 index were immunohistochemically evaluated. Fluorescence in situ hybridization was conducted for cases with equivocal immunohistochemical findings. Results: Of the 15 AC patients, 13 were menopausal, and the average age of the patients was 63.7 years. Two cases involved sequential or simultaneous bilateral development of breast cancer. Review of staging data revealed that stage 0 was 2 cases, I was seven and II was six, respectively. According to intrinsic subtype classification, one lesion was classified as luminal A, one as HER2-positive, and 13 as triple-negative lesions. Lymphatic and venous invasion were observed in eight and five cases, respectively. Among 7 patients who measured Ki67 labeling index, one case was strongly positive. As for adjuvant postoperative treatment, hormone therapy was administered in one case, anti-HER2 therapy in one case, and chemotherapy in 11 cases. No case received neo-adjuvant chemotherapy. Radiation therapy was performed in all cases after partial mastectomy. No recurrence was observed in any case with a mean follow-up period of 67.4 months.Conclusions: AC is a rare primary breast cancer characterized by an ER- and PgR-negative profile, with infrequent overexpression of HER2 protein. Although associated with a good prognosis in the present series, AC appears to be overtreated. Because AC may develop bilaterally more frequently than general invasive ductal carcinomas, particular care needs to be taken in continued monitoring of AC and other malignant lesions.
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