Primary squamous cell carcinoma of the breast: a case report and review of literature

Primary breast squamous cell carcinoma: A case report at a tertiary hospital in Northern Tanzania

Key Clinical Message

Primary SCC of the breast is a very rare disease.Metastasis from elsewhere should be excluded first.The tumor is a very aggressive with poor prognosis.No standard treatment approaches are available.Managed by surgical excision followed by chemotherapy and radiotherapy.

Abstract

Primary squamous cell carcinoma of the breast is an exceedingly rare disease, and its management is still unclear. A-65-year-old lady presented with a progressive swelling of her right breast that started spontaneously. Other potential primary sites were ruled out. She was kept on a neo-adjuvant chemotherapy (AC-T protocol) of doxorubicin, adriamycin, and paclitaxel. Later, she was underwent modified radical mastectomy with axillary lymph node dissection. Her post-operative recovery was uneventful. Currently, she is followed up at oncology outpatient clinic.

Case report: Apatinib combined with neoadjuvant therapy for primary squamous cell carcinoma of the breast: a case report

Primary squamous cell carcinoma of the breast is a rare subtype of carcinoma of chemosis for which there is no effective chemotherapy regimen. Breast squamous cell carcinoma is usually "triple negative", with poor chemotherapy effects and poor prognosis. Here, we report a successful case of primary breast squamous cell carcinoma treated with apatinib. The patient was treated with 2 cycles of apatinib. The efficacy was evaluated as partial remission, and a sublesion of approximately 4 cm fell off.

Lumpectomy Combined with Adjuvant Radiotherapy Could Be a Treatment Option for Primary Squamous Cell Carcinoma of the Breast

Background

To investigate the outcomes of primary squamous cell carcinoma (PSCC) of the breast undergoing radical surgery with or without adjuvant radiotherapy (RT).

Materials and Methods

A population cohort with histologically diagnosed PSCC of the breast was identified from the SEER database. The Kaplan-Meier method and Cox-regression proportional hazards model was used to assess the impact of surgical types with or without adjuvant RT on the cause-specific survival (CSS) and overall survival (OS). A retrospective analysis of PSCC between Jan 2010 and Dec 2018 from our institute was performed.

Results

A total of 515 patients with PSCC of the breast were included, 254 patients treated with mastectomy (MAST) alone, 78 with MAST + RT, 87 with lumpectomy (LUMP) alone, and 96 with LUMP + RT. The median follow-up time was 118 months (range: 0-379 months). In the multivariate Cox analyses, LUMP + adjuvant RT was an independent prognostic factor for CSS (p = 0.028) and OS (p = 0.048). Patients treated with LUMP + RT had better survival rates than patients who underwent lumpectomy (CSS, p = 0.034; OS, p = 0.0004), MAST alone (CSS, p = 0.0001; OS, p < 0.0001), and MAST + RT (CSS, p = 0.0001; OS, p = 0.0078), while postmastectomy RT did not significantly improve OS (p = 0.062) and CSS (p = 0.67) when compared to MAST alone. In addition, a total of 28 patients with PSCC of the breast were identified from our institute. All of these patients presented with estrogen receptor-negative type, and three of them had HER-2-positive PSCC; the median tumor size was 3 cm (range: 0.5-15 cm). Eight patients were treated with LUMP + adjuvant RT, thirteen with MAST, and seven with MAST + RT. Until the last follow-up of Sep 2021, 26 patients with PSCC were still alive and free of breast cancer, excepting that one patient treated with MAST and one patient with MAST + RT died from breast cancer.

Conclusion

PSCC of the breast after radical surgery has a poor prognosis. Adjuvant RT after LUMP significantly improves survival of patients with PSCC of the breast. Further studies are still needed to investigate the role of adjuvant RT in PSCC of the breast after mastectomy.

SOX10 - A Novel Marker for the Differential Diagnosis of Breast Metaplastic Squamous Cell Carcinoma

Introduction

Differential diagnosis of metaplastic squamous cell carcinoma of breast (MSCCB) is difficult. In particular, in terms of metastatic MSCCB, because of the low speciality of traditional markers such as mammaglobin, gross cystic disease fluid protein-15 (GCDFP-15) and GATA binding protein 3 (GATA3), the most common problem is differentiating the spread of MSCCB to the lung from a primary lung squamous cell carcinoma. It is urgently required to explore a novel marker to aid in differential diagnosis.

Aim

The aim of this study is to explore a novel marker to aid in the differential diagnosis of MSCCB from other squamous cell carcinomas (SCC) in other organs.

Methods

We tested the expression of SOX10 in 375 human SCC specimens with immunohistochemistry (IHC).

Results

In a series of 20 MSCCB, 9 (45%) were positive for SOX10. All of them were triple-negative MSCCB. Conversely, SOX10 was totally negative in another 205 SCC originating from lung, skin, cervix, oral mucosa, and esophagus. In a series of 150 triple-negative breast cancer and their metastatic foci, SOX10 labeling in the primary tumor and metastasis was 78% and 79.3%, respectively, and the agreement rate was 97.3% (P>0.05).

Conclusion

Our findings demonstrate that SOX10 was recommended for differentiating MSCCB from non-mammary metastasis to the breast, as well as for distinguishing primary SCC from metastatic MSCCB, and SOX10 may be valuable in the pathological diagnosis of breast-derived metaplastic squamous cell carcinoma.

Squamous cell carcinoma of the breast, are there two entities with distinct prognosis? A series of 39 patients

PURPOSE

Squamous cell carcinoma (SCC) of the breast is a rare entity of breast cancer, with a very poor prognosis, and whose pathophysiology is still unwell established. Therapeutic management is very heterogeneous due to its incomplete understanding. Nevertheless, it seems that two histological entities can be distinguished: pure SCC close to the cutaneous origin, and metaplastic squamous breast cancer (MSBC). The aim of this study is therefore to assess the difference in survival according to the histological type (SCC or MSBC) and to describe the demographic, clinical, and therapeutic characteristics of the two underlying populations.

METHODS

Our data came from a monocentric retrospective series of 39 patients treated between 1985 and 2018 at the Gustave Roussy Institute (France) for a breast SCC.

RESULTS

Of the 39 patients included, 64% had MSBC and 36% had a pure form. The overall and recurrence-free survival at 3 years [CI 95%] was 72.3% [56.9%; 87.0%] and 67.2% [51.2%; 83.2%], respectively. The overall 3-year survival of patients with MSBC was significantly lower than that with pure SCC: HR [CI 95%] 9.5 [1.2; 73.1], p = 0.008. The 3-year recurrence-free survival of patients with MSBC was also poorer: HR [CI 95%] 11.9 [1.6; 90.7], p = 0.002. Patients with MSBC also tended to be younger, have a large lesion size, and be more metastatic.

CONCLUSION

The histological nature of SCC seems to bring fundamental new elements to the therapeutic management as it impacts recurrence and survival. It should therefore be better characterized at diagnosis in order to possibly adapt treatments.

Squamous Cell Carcinoma of the Breast Mimicking Chronic Breast Abscess

Primary squamous cell carcinoma (SCC) of the breast is an exceedingly rare malignancy, and there are no clear management protocols for SCC of the breast. We report a 45-year-old female patient who presented with the recurrent breast abscess and a large fungating SCC of the breast with fixed ipsilateral axillary nodes. She was offered modified radical mastectomy. During the follow-up visits, she was observed to have developed multiple vertebral metastases. She had palliative chemotherapy. However, the patient succumbed to the disease within 6 months of the diagnosis.