Cutaneous and mammary apocrine carcinomas have different immunoprofiles

Hum Pathol. 2014 Feb;45(2):320-6. doi: 10.1016/j.humpath.2013.09.007. Epub 2013 Dec 14.


Often the distinction of cutaneous apocrine carcinoma from metastatic mammary apocrine carcinoma to the skin can be a diagnostic dilemma because both tumors share similar histologic features and have overlapping immunohistochemical profile. We compared the expression of adipophilin, cytokeratin 5/6, p63, GATA3, mammaglobin, androgen receptor, estrogen receptor, progesterone receptor, and HER2 by immunohistochemistry in 14 cutaneous apocrine carcinomas (11 primary tumors, 3 metastases) and 26 primary apocrine carcinomas of the breast. Whereas focal adipophilin staining was seen in 36% (5/14) of cutaneous apocrine carcinoma, strong and diffuse adipophilin staining was seen in 88% (22/25) of mammary apocrine carcinoma (P = .0013). Differences in estrogen receptor and progesterone receptor expression were also statistically significant (P = .018 and .043). Androgen receptor was strongly positive in all cutaneous and mammary cases. Although there was no significant difference in the frequency of expression of cytokeratin 5/6, p63, HER2, GATA3, and mammaglobin in cutaneous apocrine carcinoma versus mammary apocrine carcinoma, strong and diffuse cytokeratin 5/6 and/or mammaglobin expression were seen only in cutaneous apocrine carcinoma. In conclusion, cutaneous apocrine carcinoma is likely adipophilin- ER+ PR+/- HER2- and can exhibit strong and diffuse cytokeratin 5/6 and/or mammaglobin expression. On the contrary, a mammary apocrine carcinoma is likely adipophilin+ ER- PR- and often exhibit 3+ HER2 with corresponding HER2 gene amplification. A panel of adipophilin, ER, PR, HER2, cytokeratin 5/6, and mammaglobin may be helpful in distinguishing cutaneous apocrine carcinoma from mammary apocrine carcinoma.

Keywords: Adipophilin; Androgen receptor; Cytokeratin 5/6; Estrogen receptor; GATA3; HER2/neu; Mammaglobin; Progesterone receptor; p63.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / biosynthesis*
  • Breast Neoplasms / diagnosis
  • Breast Neoplasms / immunology*
  • Breast Neoplasms / pathology
  • Estrogen Receptor alpha / biosynthesis
  • Female
  • GATA3 Transcription Factor / biosynthesis
  • Humans
  • Immunohistochemistry
  • Keratin-5 / biosynthesis
  • Keratin-6 / biosynthesis
  • Male
  • Mammaglobin A / biosynthesis
  • Membrane Proteins / biosynthesis
  • Middle Aged
  • Perilipin-2
  • Receptor, ErbB-2 / biosynthesis
  • Receptors, Androgen / biosynthesis
  • Receptors, Progesterone / biosynthesis
  • Retrospective Studies
  • Skin Neoplasms / diagnosis
  • Skin Neoplasms / immunology*
  • Skin Neoplasms / pathology
  • Skin Neoplasms / secondary
  • Sweat Gland Neoplasms / genetics
  • Sweat Gland Neoplasms / immunology*
  • Sweat Gland Neoplasms / pathology


  • AR protein, human
  • Biomarkers, Tumor
  • CKAP4 protein, human
  • ESR1 protein, human
  • Estrogen Receptor alpha
  • GATA3 Transcription Factor
  • GATA3 protein, human
  • Keratin-5
  • Keratin-6
  • Mammaglobin A
  • Membrane Proteins
  • PLIN2 protein, human
  • Perilipin-2
  • Receptors, Androgen
  • Receptors, Progesterone
  • Receptor, ErbB-2