Department of Plastic and Reconstructive Surgery, Gustave Roussy, 114 Rue Edouard Vaillant, 94800, Villejuif, France.
INSERM U1018, CESP, Fac. de Médecine-Univ. Paris-Sud-UVSQ, INSERM, Université Paris-Saclay, 94807, Villejuif Cedex, France.
Breast Cancer Res Treat. 2020 Feb;180(1):87-95. doi: 10.1007/s10549-020-05525-5. Epub 2020 Jan 22.
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.
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.
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.
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.
乳腺的鳞状细胞癌（SCC）是一种罕见的乳腺癌实体，预后极差，其病理生理学仍未得到充分证实。由于对其认识不完整，治疗管理非常多样化。然而，似乎可以区分两种组织学实体：靠近皮肤起源的单纯 SCC 和间变性鳞状乳腺癌（MSBC）。因此，本研究的目的是评估根据组织学类型（SCC 或 MSBC）的生存差异，并描述两种潜在人群的人口统计学、临床和治疗特征。
我们的数据来自于 1985 年至 2018 年期间在 Gustave Roussy 研究所（法国）接受治疗的 39 例乳腺 SCC 的单中心回顾性系列。
在纳入的 39 例患者中，64%为 MSBC，36%为纯型。3 年总生存率[95%CI]为 72.3%[56.9%；87.0%]和无复发生存率为 67.2%[51.2%；83.2%]。MSBC 患者的 3 年总生存率明显低于单纯 SCC 患者：HR[95%CI]9.5[1.2；73.1]，p=0.008。MSBC 患者的 3 年无复发生存率也较差：HR[95%CI]11.9[1.6；90.7]，p=0.002。MSBC 患者也倾向于更年轻，肿瘤更大，转移更多。
SCC 的组织学性质似乎为治疗管理带来了根本性的新元素，因为它会影响复发和生存。因此，在诊断时应更好地对其进行特征描述，以便可能调整治疗方法。
