Basal Cell Carcinoma in Breast Simulating Invasive Carcinoma: Case Report

Abstract

INTRODUCTION: Basal cell carcinoma (BCC) is the most common type of skin cancer, comprising about 75% of all skin tumors. It is derived from the basal cell layer of the epidermis and has slow and progressive growth. Its prevalence is higher from the fourth decade of life, with peak incidence in the sixth decade in both sexes. BCC occurs most often in areas exposed to sunlight, the nose being the most frequent site, but also may develop in covered areas and in unusual locations, making difficult the early diagnosis and treatment. This study aims to present a rare case of BCC in the breast. REPORT: Female patient, 69 years searched for a mastology service at LNRCC, Natal on 10/05/2011 referring wound in the left breast since five years ago. Physical examination: lesion of 7 x 7 cm in medial upper quadrant of the left breast, close to the sternum and ulcerated. Free armpits and breasts without palpable nodules. We ordered a mammogram which resulted in BIRADS 2. She was then submitted to byopsy by Punch that showed, infiltrating carcinoma of basaloid cells with infiltrating of the dermis. On 01/08/2011 was performed excision of the ulcerated lesion in the medial upper quadrant of the left breast with rotation of myocutaneous flap. Pathologic examination revealed an ulcerated lesion with raised edges measuring 6.5 cm in greatest diameter and the conclusion was basal cell carcinoma of solid pattern with infiltration of the hypodermis and free surgical margins. The patient developed postoperative and follow-up every six months without complications. There was no indication of radiation. DISCUSSION: in general, the sites considered unusual for the occurrence of BCC are breast, periungual region, palmar, plantar, gluteal and intertriginous areas (axilla, groin and genitalia). The reason for this report is to alert mastologists about the possibility of the BCC in the breast, because despite its rare occurrence, it must be included in the differential diagnosis of invasive breast carcinomas with involvement of the skin that affect this region more frequently.