A 42-year-old female presented to Surgical OPD of our hospital, with history of lump in the upper inner quadrant of her right breast, for which lumpectomy was done outside and sent for histopathological examination, one month back, histopathology report was given as Invasive ductal carcinoma. There was no history of any nipple retraction and discharge, no significant past history of tuberculosis, and so forth. The patient was afebrile with no abnormality detected on general physical examination. Local examination of the right breast showed a linear scar mark, medial to the nipple. The breast was tender to touch while no mass lesion was felt. Left breast was unremarkable with no axillary lymphadenopathy. In view of the histopathology report, right-sided modified radical mastectomy (MRM) was performed at our hospital and excised specimen was sent for histopathological examination.
Right MRM specimen measuring 17 x 16.5 x 3 cm and weighing 500 gms was grossed. Overlying skin showed a scar mark. Serial cut section revealed a cavity (postlumpectomy); however, no any residual tumor could be appreciated on gross examination, representative bits were processed, and H&E stained tissue sections were obtained. Outside slide and blocks reported as invasive ductal carcinoma were also reviewed.
On light microscopy, outside slides (from lump) showed a tumor composed of large cells arranged in tubules, glandular pattern, and sheets, having abundant eosinophilic granular cytoplasm with distinct cell margins, large round nuclei with vesicular chromatin pattern, and occasional prominent nucleoli. Tumor cells showed PAS positivity with diastase resistance. Bloom Richardson score was 2 + 2 + 1 = 5 (Grade I). Also noted was marked adenosis with apocrine metaplasia in the adjacent breast tissue (Figures 1 and 2). 
Sections from MRM specimen revealed minimal residual tumor with surrounding breast tissue showing marked adenosis with apocrine metaplasia. Also noted was foreign body giant-cell reaction in the overlying skin:consistent with prior history of surgery (lumpectomy). Final diagnosis was given as invasive apocrine carcinoma, right breast, with minimal residual tumor in MRM specimen. All lymph nodes, surgical margins, skin, nipple, and areola were free from tumor. Immunohistochemistry was done which showed estrogen and progesterone receptor negative, androgen receptor positive (ER-/PR-/AR+).