Loving Bailey A, Sivapalan Shaveena, Schukow Casey P, Khaira Jashan, Vicini Frank A, Fontanesi James
Radiation Oncology, Corewell Health, Royal Oak, USA.
Radiation Oncology, Michigan State University, Auburn Hills, USA.
Cureus. 2024 May 1;16(5):e59447. doi: 10.7759/cureus.59447. eCollection 2024 May.
This case report details a rare instance of primary squamous cell carcinoma (PSCC) of the breast in an octogenarian, emphasizing the unique diagnostic and treatment challenges posed by this malignancy in an elderly patient and adding to the scientific literature on PSCC managed with breast conservation therapy (BCT). An 80-year-old woman with medical comorbidities presented with a focal asymmetry in the right breast's retroareolar plane, detected during routine screening mammography. Diagnostic evaluations raised high suspicion for malignancy, confirmed as PSCC by ultrasound-guided biopsy. Histopathological analysis showed atypical keratinizing squamous epithelial nests and cysts. The patient underwent lumpectomy and re-excision of close surgical margins with a sentinel lymph node biopsy, which showed well-differentiated invasive squamous cell carcinoma with no residual carcinoma or nodal involvement. She was treated with adjuvant hypofractionated radiation therapy, experiencing minimal side effects. This case highlights the importance of considering individualized, nuanced approaches to adjuvant therapies in the treatment of PSCC in older patients. It demonstrates that BCT, coupled with carefully selected adjuvant therapy, can be a successful treatment strategy for PSCC in the elderly, contributing valuable insights into the management of this rare condition.
本病例报告详细介绍了一名八旬老人患原发性乳腺鳞状细胞癌(PSCC)的罕见病例,强调了这种恶性肿瘤给老年患者带来的独特诊断和治疗挑战,并为有关采用保乳治疗(BCT)管理PSCC的科学文献增添了内容。一名患有多种内科合并症的80岁女性在常规筛查乳腺钼靶检查时,发现右乳晕后平面有局灶性不对称。诊断评估高度怀疑为恶性肿瘤,经超声引导下活检确诊为PSCC。组织病理学分析显示非典型角化鳞状上皮巢和囊肿。患者接受了肿块切除术,并对切缘进行了再次切除,同时进行了前哨淋巴结活检,结果显示为高分化浸润性鳞状细胞癌,无残留癌或淋巴结受累。她接受了辅助性大分割放疗,副作用极小。本病例强调了在老年患者PSCC治疗中考虑个体化、细致入微的辅助治疗方法的重要性。它表明,BCT加上精心选择的辅助治疗,可以成为老年PSCC患者的一种成功治疗策略,为这种罕见疾病的管理提供了宝贵的见解。