Apocrine metaplasia is a benign (noncancerous) change in which the normal cells lining a tissue are replaced by cells that resemble apocrine cells, a special type of glandular cell normally found in the skin. The word metaplasia refers to the replacement of one type of mature cell by another. Apocrine metaplasia is very common, especially in the breast. It is not cancer and is not considered precancerous.
Apocrine metaplasia is a description of how cells look rather than a disease in itself. It is usually noted among several findings in a sample, often as part of another benign condition such as fibrocystic change, rather than appearing as a diagnosis on its own. This article explains what apocrine metaplasia is and why it may appear in your pathology report.
What does apocrine metaplasia look like under the microscope?
Under the microscope, the apocrine cells that characterize apocrine metaplasia are usually large and round, with a visible central nucleolus (a small structure within the nucleus). Their cytoplasm, the material surrounding the nucleus, often looks pink and granular on a standard hematoxylin and eosin (H&E) stained slide. These features make apocrine metaplasia easy for pathologists to recognize.
Where does apocrine metaplasia usually occur?
Although apocrine metaplasia can occur in different parts of the body, it is most often seen in the breast, where it is commonly associated with benign conditions such as:
- Fibrocystic change.
- Benign breast cysts.
- Usual ductal hyperplasia (UDH).
Hormonal changes are thought to play a role in the development of apocrine metaplasia in the breast.
How is apocrine metaplasia different from other apocrine changes?
It is important to distinguish apocrine metaplasia from other conditions that also involve apocrine cells:
- Apocrine hyperplasia — A benign condition in which the number of apocrine cells increases.
- Apocrine carcinoma — A rare type of breast cancer that develops from malignant (cancerous) apocrine cells.
Unlike apocrine carcinoma, apocrine metaplasia does not increase the risk of developing breast cancer.
How is apocrine metaplasia identified?
Apocrine metaplasia is identified by a pathologist who examines a tissue sample under the microscope. The sample is usually obtained during a biopsy performed to investigate a lump or other change in the breast. Because apocrine metaplasia is a descriptive finding rather than the reason for the biopsy, the pathologist simply notes it and carefully examines the rest of the sample to ensure there are no other findings that require attention.
Questions to ask your doctor
- What was the reason for my biopsy?
- Was apocrine metaplasia the only finding in my pathology report?
- Could the apocrine metaplasia be related to fibrocystic change or another benign breast condition?
- Do I need any follow-up tests or treatment?
- Does this finding change my risk of breast cancer?
- Should I continue routine breast screening as usual?
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