Pure apocrine breast carcinoma is a rare subgroup of breast carcinomas which exits 1-4% of all breast malignancies. A 53 years old woman with a follow-up for 2 years by breast diseases outpatient clinic reevaluated due to the differences in the left breast microcalcification lesions in mammography examination. Physical examination revealed no breast lesion in left beast. Mobile lymph nodes were palpated in left axillary fossa. The mammographic examination of the left breast demonstrated clustered pleomorphic microcalcifications and pathologic lymph nodes. Stereotactic vacuum biopsy was performed by breast radiology department and the histopathologic examination of the specimen was pure apocrine breast carcinoma. After guide wire localization of the lesion wide local excision and level II axillary dissection were performed under general anesthesia. 4 of 19 dissected lymph nodes were evaluated as metastasis with apocrine carcinoma. The patient was referred to breast oncology department for adjuvant therapy. The patient has no recurrent tumor or distant metastasis in follow up. As there is no agreement on the treatment protocols of the apocrine breast carcinomas, the treatment strategy must be arranged due to the lesions features, patient's demands, and adjuvant treatment possibilities. We believe that every single case of apocrine breast carcinoma should be reported in order to observe the difference of apocrine breast cancers and to constitute a treatment consensus protocol.