The challenges and pitfalls of diagnosing adenomyoepithelioma in needle core biopsies of the breast

Abstract

Adenomyoepithelioma (AME) is a rare mammary neoplasm characterized by a biphasic proliferation of both myoepithelial and epithelial cells. These two cellular populations can contribute disproportionately to the lesion and assume a wide spectrum of growth patterns and histopathological features. Further, large variations exist in clinical presentation and imaging findings. A clear challenge that therefore arises is identifying AME on limited core biopsy material. As there are numerous potential mimickers of AME depending on the sampled region, accurate diagnosis of the entity is crucial. Recognizing the dual nature of AME and the architectural features it can possess, in combination with a panel of immunohistochemical markers, is necessary to establishing a diagnosis. Herein, we present a comprehensive approach and guiding principles to reaching a definitive diagnosis of AME on breast needle core biopsies.

Keywords

• Adenomyoepithelioma
• Breast
• Core biopsy
• Immunohistochemistry