Digital Atlas of Breast Pathology by Meenakshi Singh, MD © - Department of Pathology, Stony Brook University Medical Center

Apocrine adenosis.
While cell proliferation is clearly evident, the adenosis remains largely confined to a lobule.

Digital Atlas of Breast Pathology by Meenakshi Singh, MD © - Department of Pathology, Stony Brook University Medical Center

Apocrine adenosis and sclerosing adenosis
Glandular arrangement similar to sclerosing adenosis with focal eosinophilic cells with apical snout formation and decapitation secretion characteristic of apocrine differentiation.

Look in high power carefully and myoepthelial can be appreciated. So clearly it is not invasive cancer.

Another possibility is DCIS invlolving 硬化性腺病. The growth pattern and cytomorphology do not support DCIS invlolving 硬化性腺病.

It is 硬化性腺病 with reactive change (treatment related?) or apocrine change.

这个病例很具有挑战性，想说良性不放心，想说恶性证据不足。这例的病史+年龄，要非常警惕是否复发？？？

腺样结构，上皮细胞核也存在一定的异型性；缺乏典型的小叶性结构，中央也不见星状疤痕，所以，觉得诊断硬化性腺病也不够典型。

还是做上一组免疫组化，看看有没有帮助；如此有挑战性的病例，还是多几个专家会会诊吧。别把这么烫手的山芋留在自己的手里。

      整个背景是硬化性腺病，只是不敢确定这一团细胞的良恶性。从高倍镜看肌上皮应该是存在的。