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Adenomyoepithelioma of the breast: A proposal for classification

Rakha, Emad; Hoon Tan, Puay; Ellis, Ian; Quinn, Cecily

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Professor of Breast Cancer Pathology

Puay Hoon Tan

Cecily Quinn


Breast lesions with a prominent myoepithelial cell component constitute a heterogeneous group of benign and malignant neoplastic proliferations. These lesions are often dual epithelial‐myoepithelial but may be purely myoepithelial cell in nature. Benign epithelial‐myoepithelial lesions typically maintain the morphology and immunophenotype of the normal bilayer epithelial myoepithelial structures. However, the distinction between the two cell components is not always clear‐cut in malignant lesions in which the histogenesis of myoepithelial cells remains uncertain. Neoplastic biphasic epithelial‐myoepithelial lesions of the breast include adenomyoepithelioma (AME), pleomorphic adenoma and adenoid cystic carcinoma. Four histological patterns of classical AME have been described: tubular, lobulated, spindle cell and adenosis variants. Overlapping patterns occur and some AMEs display an intraductal papillary pattern that may represent a fifth variant. AME can be benign or malignant. Classical AME may show atypical features, which are not sufficient for the diagnosis of malignancy (atypical AME). Atypical AME is recognised as a lesion of uncertain malignant potential with limited metastatic capability. Based on the histological features, we propose a classification of malignant AME (M‐AME) into three variants: M‐AME in situ, M‐AME invasive and AME with invasive carcinoma. In this review, we provide an overview of myoepithelial lesions of the breast focusing on the classification of AME to improve not only the consistency of reporting but also help guide further management decision making.


Rakha, E., Hoon Tan, P., Ellis, I., & Quinn, C. (2021). Adenomyoepithelioma of the breast: A proposal for classification. Histopathology, 79(4), 465-479.

Journal Article Type Article
Acceptance Date Apr 4, 2021
Online Publication Date Jun 13, 2021
Publication Date 2021-10
Deposit Date Apr 20, 2021
Publicly Available Date Jun 14, 2022
Journal Histopathology
Print ISSN 0309-0167
Electronic ISSN 1365-2559
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 79
Issue 4
Pages 465-479
Keywords Pathology and Forensic Medicine; Histology; General Medicine
Public URL
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