Stevenson J T, Graham D J, Khiyami A, Mansour E G
Department of Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
Ann Surg Oncol. 1996 Jul;3(4):367-74. doi: 10.1007/BF02305666.
Squamous cell carcinoma (SCC) of the breast is rare. It remains unclear whether a "pure" form of SCC exists or if all known cases actually represent an extreme form of squamous metaplasia within adenocarcinoma. Due to its rarity and controversy over its definition, there are no good data on appropriate management and prognosis.
All cases of breast carcinoma indexed at our institution were reviewed to identify seven cases where squamous metaplasia was a significant component of the pathologic diagnosis. Slides and electron micrographs were reviewed by a single pathologist. Clinical information was obtained from medical records.
These cases support the concept of a disease continuum with varying degrees of squamous metaplasia. When tumors identified as "pure" SCC on light microscopy are subjected to ultrastructural analysis, either separate squamous and glandular cells are present or both histologic features are noted to coexist in the same cell.
Identification of "pure" cases of SCC appears clinically unimportant. All patients presented with advanced disease, thus necessitating aggressive management regardless of histology. Mastectomy was performed due to large tumor size and adjuvant chemotherapy given rather than hormones because of receptor negativity. The mixed histology should direct future drug choice. The role of radiation remains unclear.
乳腺鳞状细胞癌（SCC）较为罕见。目前尚不清楚是否存在“纯粹”形式的SCC，或者所有已知病例实际上是否代表腺癌内鳞状化生的一种极端形式。由于其罕见性以及对其定义存在争议，关于适当管理和预后方面没有良好的数据。
对本机构索引的所有乳腺癌病例进行回顾，以识别7例鳞状化生是病理诊断重要组成部分的病例。由一名病理学家审查切片和电子显微镜照片。从医疗记录中获取临床信息。
这些病例支持疾病连续体的概念，即存在不同程度的鳞状化生。当在光学显微镜下被鉴定为“纯粹”SCC的肿瘤进行超微结构分析时，要么存在单独的鳞状细胞和腺细胞，要么在同一细胞中同时存在两种组织学特征。
识别“纯粹”的SCC病例在临床上似乎并不重要。所有患者均表现为晚期疾病，因此无论组织学如何都需要积极治疗。由于肿瘤体积大而进行了乳房切除术，并且由于受体阴性而给予辅助化疗而非激素治疗。混合组织学应指导未来的药物选择。放疗的作用仍不清楚。
