Minagawa Mari, Kanzaki Masaki, Takano Yutaka, Nishikawa Takeshi, Deie Kyoichi, Minami Yasuhiro, Maeda Mamoru, Teshima Shinichi
Dept. of Surgery, The Fraternity Memorial Hospital, Japan.
Gan To Kagaku Ryoho. 2012 Jul;39(7):1111-4.
Squamous cell carcinoma(SCC)of the breast is a rare pathological-type cancer with an unclear origin. It has been suggested that breast SCC may originate from squamous metaplasia of the ductal epithelium. We report a case of SCC of the breast which histological carcinoma type changed after neoadjuvant chemotherapy. A 66-year-old woman visited our hospital for a tumor of the left breast. Mammography indicated breast cancer. On CT scan the tumor was 40mm in diameter, and was located in the upper lateral quadrant of the left breast. Because she requested breast-conserving surgery, core needle biopsy(CNB)was performed. The histological findings showed solid-tubular adenocarcinoma, PgR(-), ER(-), HER2(-), cT2cN1cM0, cStage II B. She received neoadjuvant chemotherapy consisting of 4 courses of CEF(cyclophosphamide, epirubicin, 5-fluorouracil)and 3 courses of paclitaxel. After chemotherapy, she was considered to have progressive disease, and a modified radical mastectomy was performed. The resected tumor was cystic and 60mm in diameter, containing muddy fluid. Histopathological examination showed pure squamous cell carcinoma, PgR(-), ER(-), HER2(-), pT3pN0pM0, pStage II B. The cancer metastasized with the light axillary lymph nodes at the 6th month after the operation, and she underwent chemo-radiation therapy. She died 6 years after the operation from brain metastasis.
乳腺鳞状细胞癌（SCC）是一种起源不明的罕见病理类型癌症。有研究表明，乳腺SCC可能起源于导管上皮的鳞状化生。我们报告一例乳腺SCC病例，其组织学癌类型在新辅助化疗后发生了改变。一名66岁女性因左乳肿物前来我院就诊。乳腺钼靶检查提示乳腺癌。CT扫描显示肿瘤直径为40mm，位于左乳外上象限。由于她要求保乳手术，遂进行了粗针穿刺活检（CNB）。组织学检查结果显示为实体-管状腺癌，孕激素受体（PgR）（-），雌激素受体（ER）（-），人表皮生长因子受体2（HER2）（-），临床分期为T2cN1cM0，c期IIB。她接受了由4个疗程的CEF（环磷酰胺、表柔比星、5-氟尿嘧啶）和3个疗程的紫杉醇组成的新辅助化疗。化疗后，她被认为疾病进展，遂进行了改良根治性乳房切除术。切除的肿瘤为囊性，直径60mm，内含浑浊液体。组织病理学检查显示为纯鳞状细胞癌，PgR（-），ER（-），HER2（-），病理分期为T3pN0pM0，p期IIB。术后6个月癌症转移至腋窝浅淋巴结，她接受了放化疗。术后6年她死于脑转移。
