Mirza Kamran Abbas, Habib Qadir, Asim Shabbir, Faiza lmran, Imtiaz Rasool, Nosheen W Yousuf.
Primary Squamous Cell Carcinoma of Female Breast a Rare Entity.
J Coll Physicians Surg Pak Jan ;10(5):185-6.

Squamous cell carcinoma arising from the breast tissue is a very rare histological variant of breast cancer. It lacks any typical mammographic features and appears cystic on ultrasonography. A case of well-differentiated pure squamous cell carcinoma with axillary lymph node metastasis in a pre-menopausal woman is presented. She was treated with modified radical mastectomy and postoperative chemotherapy.

CASE REPORT: A female patient named N.A., aged 40 years, was admitted in the surgical unit 4 of Jinnah Hospital, Lahore on October 29, 1999 with the complaint of a lump in her right breast. She noticed this lump three months back. Initially, it was small but gradually increased in size. There was no complaint of pain in the beginning but for the last 2 weeks prior to admission in hospital she felt dull ache. There was no H/O nipple discharge. She had never used contraceptive pills. There was neither any complaint of anorexia, weight loss, cough nor any r associated symptom. She was married and had five kids who were all breastfed. There was no family history of breast cancer. On physical examination, there was a visible swelling in her right breast in lower outer quadrant involving areola but not nipple. It was rounded in shape measuring 5cm in diameter.It was was hard in consistency with well-defined margins. Overlying skin was red in colour with no change in tempera. There was no peau-d-orange. The skin was tethered with swelling, which was mobile over the underlying muscle. Illumination was not present. Axillary lymph node palpable, especially the medial, central and posterior lymph nodes. These were hard in consistency, and movable. Supraclavicular lymph nodes were not palpable The breast ultrasound showed a complex mass predominantly solid with cystic changes, regular in outline measuring 1.5 x 5 cm in size. Fine needle aspiration cytology revealed the presence of malignant cells in the aspirate. Complete blood count revealed normal values and X-ray chest PA view showed no pulmonary metastasis. On abdominal ultrasound no abnormality was noticed. Right sided modified radical mastectomy was performed and the specimen of breast with axillary lymph nodes was sent for histopathology. The wound was closed with two suction drains. The patient had uneventful recovery. Drains and titches were removed subsequently on 7th and 10th postoperative days. The patient was finally referred to medical oncology department for receiving chemotherapy. Histological examination of the resected specimen showed well differentiated pure squamous cell carcinoma of breast. Six out of eleven lymph nodes examined by the pathologist showed tumour metastasis.

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