Pure Primary Squamous Cell Carcinomas of the Breast: A Report of Eight Cases

Kaoutar Znati, Sanaa Bennis, Fouad Abbas, Meriam Chraibi, Nawal Hammas, Sanae Chahbouni, Taoufiq Harmouch, Laila Chbani, Hinde Elfatemi, Yousra Aksbi, Samia Arifi, Omar Mesbahi, Afaf Amarti

Abstract


         Pure primary squamous cell carcinoma (PPSCC) of the breast is a rare neoplasm included in World Health Organization Classification of tumors (2003) in metaplastic breast cancer. It accounts for less than 0.1% of all breast carcinomas. We performed a retrospective review of all women diagnosed or treated as PPSCC, from January 2004 to June 2009 to assess clinical presentation, surgical and pathological findings, treatment and outcome. Eight patients were identified. The median age was 48.2 (range: 40 - 57) years. The average tumor size was 7.3 cm, with a range of 3.5 to 18 cm. There were one well differentiated, three moderately differentiated and four poorly differentiated PPSCC. Two cases were stage IIA, two cases stage IIIA and three cases stage IIIB. Primary treatment was mastectomy in six patients and large local excision in one patient. There was lymph node (LN) involvement in one patient. Estrogen and progesterone receptors status and over expression of HER 2 were assessed and none tumors was positive. Cytokeratin 5/6 and/or Cytokeratin 14 were positive in all tumors. All patients were treated by radiotherapy and chemotherapy. Though PPSCC of the breast is a very rare and aggressive disease, in our experience it’s relatively frequent. Strict histologic criteria should be used to diagnose PPSCC, because they have significantly lower axillary lymph node metastasis, lower estrogen and PR positivity, and they are often treatment-refractory. The role of different new chemotherapy regimens needs to be explored.




doi:10.4021/jmc2010.07.105e

Keywords


Pure squamous cell carcinoma; Metaplastic carcinoma; Breast; Morphology; Basal-like phenotype; Histogenesis; Prognosis; Treatment

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