Abstract

Background: Despite the variety of epithelial malignancies seen in the breast, primary squamous cell carcinoma (SCC) of the breast is rare. It was often classified as one of the metaplastic carcinomas of the breast, although it can arise denovo from benign cysts in the breast. The reported incidence is less than 0.1% of all the ductal carcinomata. It has no distinct clinical features and radiological appearances are also unremarkable. Case report: We managed a 43-year-old housewife at the General Surgery Unit of University of Maiduguri Teaching Hospital Borno State-Nigeria, who presented with an 11-month old left breast lump that developed malignant features 2 months prior to presentation. A diagnostic Ultra Sound Scan revealed a 10cm retroareola cystic mass with irregular margins and no colour flow on Doppler interrogation, with a provisional diagnosis of a chronic breast abscess. A Fine Needle Aspiration Cytology was equivocal. A wide local excision with axillary dissection was done and postoperative histopathologic analysis showed a primary squamous cell carcinoma. The resection margins were free and only one lymph node showed metastatic deposit. Conclusion: Adenocarcinoma of the breast is the most common malignancy in the breast. The absence of primary squamous cells in the breast renders pure squamous cell carcinoma a rarity. The presentation of squamous cell carcinoma could be similar to that of an adenocarcinoma or bears a benign outlook. It is imperative therefore to subject all benign lesions of the breast to pathological analysis after removal.

Highlights

  • Breast cancer is the most common malignancy seen in women, responsible for 25% of all cancers seen [1]

  • It is important to differentiate from histopathological assessment, a primary Squamous Cell Carcinoma (SCC) of the breast from secondaries, either from direct extension from overlying skin or from extra mammary origin

  • There is no consensus on the origin of squamous cell carcinoma, whether it is a pure form of squamous cell carcinoma or it represents an extreme squamous metaplasia of an existing adenocarcinoma [39]

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Summary

Conclusion

A primary squamous cell carcinoma of the breast is of clinical significance, because it can masquerade as a benign mass or arise within an existing adenocarcinoma. It’s often high histological grade, lack of hormone receptor positivity and often poor response to adjuvant care make its treatment herculean. Every benign breast mass removed must be subjected to pathological analysis, especially chronic cysts and abscesses. Aliyu S and Ningi AB co-wrote the paper and together with UZOCHI E and TEMITOPE SA took part in the care of the patient. AB Zarami helped in preparation and examination of the specimen

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