Varughese Bhirrinta, Sharif Siti Zubaidah, Yee Ho Kah, Sahid Nik Lah Nik Amin
Breast and Endocrine Unit, Surgery Department, Hospital Queen Elizabeth 2, Kota Kinabalu, Sabah, Malaysia.
Surgical Department, Faculty of Medicine & Health Sciences, University Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia.
Ann Med Surg (Lond). 2022 May 18;78:103825. doi: 10.1016/j.amsu.2022.103825. eCollection 2022 Jun.
Breast Squamous Cell Carcinoma (SCC) is quite a rare tumour that the features portray squamous cell differentiation.
We report a case of a 56-year-old female presented left breast lump that had been increasing in size for a 7 months duration associated with nipple retraction for one week. Ultrasound breast was done and revealed a large mixed echo density mass lesion in the left breast at 12 o'clock, 2cm from the nipple and measuring 4.2 × 3.4cm along with an enlarged node in the left axilla with thickened cortex and as for Mammogram revealed suspicious left breast lesion with enlarged axillary nodes, BIRADS 5. Histopathology from the left breast showed Invasive carcinoma with squamous differentiation, B5b, ER: negative, PR: Positive, Her2: Negative, CK5/6: Positive. Then a staging CECT Thorax, Abdomen and Pelvis was done which showed enhancing mass lesion seen at the left breast (4.1 × 4.3cm) with areas of necrosis within and multiple enlarged left axillary nodes seen with no local infiltration to the muscle or skin as well as no distant metastases. Patient underwent Neoadjuvant chemotherapy for 6 cycles and completed them.
This case highlights the crucial need of early detection along with the obstacles faced in reaching an early diagnosis tagged with the lack of guideline to manage this patient.
In the management of Breast Squamous Cell Carcinoma, the standard treatment would be to go for mastectomy with axillary clearance. However, the prognosis usually depends on the tumour size and the advance age of the patient as described in this article.
乳腺鳞状细胞癌（SCC）是一种相当罕见的肿瘤，其特征表现为鳞状细胞分化。
我们报告一例56岁女性，出现左侧乳房肿块，肿块大小在7个月内不断增大，并伴有乳头回缩一周。进行了乳腺超声检查，结果显示左侧乳房12点位置距乳头2cm处有一个大的混合回声密度肿块病变，大小为4.2×3.4cm，同时左侧腋窝有一个肿大淋巴结，皮质增厚。乳腺钼靶检查显示左侧乳房有可疑病变，腋窝淋巴结肿大，BIRADS 5级。左侧乳房组织病理学检查显示为具有鳞状分化的浸润性癌，B5b，雌激素受体（ER）：阴性，孕激素受体（PR）：阳性，人表皮生长因子受体2（Her2）：阴性，细胞角蛋白5/6（CK5/6）：阳性。随后进行了胸部、腹部和盆腔的增强CT检查，结果显示左侧乳房有一个强化肿块病变（4.1×4.3cm），内部有坏死区域，左侧腋窝有多个肿大淋巴结，未发现局部侵犯肌肉或皮肤，也没有远处转移。患者接受了6个周期的新辅助化疗并完成治疗。
该病例凸显了早期检测的迫切需求以及在早期诊断过程中面临的障碍，同时也表明缺乏管理此类患者的指南。
在乳腺鳞状细胞癌的治疗中，标准治疗方法是进行乳房切除术并清扫腋窝淋巴结。然而，如本文所述，预后通常取决于肿瘤大小和患者的高龄。
