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. 2023 Aug 31;202(3):563–573. doi: 10.1007/s10549-023-07078-9

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© The Author(s) 2023

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 1 — Histological and immunohistochemical features of LGASC with high-grade transformation (Case 1). a and b Histological features of core-needle biopsy. a The slide shows irregular dilation of the ducts with secretion in the lumen and moderate chronic inflammation in the stroma. b The immunohistochemical study showed that p40-positive cells existed discontinuously in the periphery of the ducts. c–h Histological findings of mastectomy specimens. c and d The superficial area. c The superficial area of the tumor consists of infiltrative glandular structures filled with abundant secretory materials in the lumen, resembling secretory carcinoma. The nuclear atypia of the tumor cells is bland. Few cells have mucin in their cytoplasm. d A view of a few tumor nests reveals squamous differentiation. e The deep area. The tumor displays clearer squamous cell differentiation. Some gland formations in the nests are seen. These findings are compatible with squamous cell carcinoma with the adenosquamous carcinoma pattern. f and g Histological findings of an axillary mass. f The lesions consisted of adenosquamous and spindle cell carcinoma. g Pure squamous cell carcinoma with a keratinization component is seen. h Some metastatic foci in the dissected lymph nodes include the LGASC component. Scale bar = 0.1 mm. LGASC, low-grade adenosquamous carcinoma