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Breast malignant, males, children

Carcinoma subtypes

Squamous cell carcinoma


Reviewer: Monika Roychowdhury, M.D. (see Reviewers page)
Revised: 4 November 2012, last major update August 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

See also acantholytic subtype

Definition
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● Primary breast carcinoma composed entirely of metaplastic squamous cells with variable keratin or spindle cells

Clinical features
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● Very rare (< 0.2% of breast primaries) if exclude cutaneous tumors, squamous component of phyllodes tumors and squamous-like areas of medullary carcinoma (Hum Pathol 1984;15:526)
● Aggressive and often refractory to treatment (Eur J Obstet Gynecol Reprod Biol 2008;137:222, J Clin Oncol 2005;23:7827)

Case reports
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● 32 year old lactating woman (Jpn J Clin Oncol 2000;30:279)
● 55 year old woman with cerebellar metastases (Fukushima J Med Sci 2005;51:105)
● 61 year old woman presenting with breast abscess (Breast Dis 2011;33:125); another case presenting as abscess (Clin Breast Cancer 2007;7:713)
● 71 year old woman with intracystic tumor (Breast Cancer 2007;14:109)
● 82 year old woman (World J Surg Oncol 2008;6:135)
● Two cases (Arch Pathol Lab Med 1984;108:893)

Treatment
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● Possibly cisplatin based chemotherapy (Clin Breast Cancer 2009;9:187)

Gross description
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● May have central cyst with keratin

Gross images
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Circumscribed and hemorrhagic tumor


Partially cystic tumor (arrows at margins, AFIP)

Micro description
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● Tumor composed entirely of malignant squamous cells with variable keratinization and spindle cells
● Bland squamous cells may line cystic spaces
● May represent squamous metaplasia in ductal carcinoma
● May have prominent myxoid stroma

Micro images
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Keratinizing tumor     Non-keratinizing tumor

AFIP images:
    
Poorly differentiated tumor with acantholysis and keratin pearl


Squamous cell carcinoma with transition to metaplastic spindle cells and early acantholytic changes


Spaces between tumor cells may be mistaken for vessels

Non-keratinizing tumor #1;   #2

Cytology description
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● Squamous cells, isolated and in aggregates and at various stages of maturation (Diagn Cytopathol 2007;35:429)

Cytology images
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Polygonal tumor cells with abundant eosinophilic cytoplasm and nucleus hyperchromasia #1;   #2

Positive stains
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● EGFR (85%, Int J Surg Pathol 2005;13:319), 34betaE12, CK5/6 (75%), p63 (70%)
● High Ki-67 (Anticancer Res 2007;27:547)

Negative stains
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● ER, PR and HER2 (93%)
● Mucin, CEA and vascular markers

Electron microscopy description
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● May have glandular features ultrastructurally (Arch Pathol Lab Med 1980;104:130)

Differential diagnosis
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● Post-traumatic lobular squamous metaplasia (Mod Pathol 1988;1:385)
● Other squamous metaplasia (Eur J Cancer Care (Engl) 2009;18:650)
Metastasis to breast: see Anticancer Res 2008;28:1299

End of Breast malignant, males, children > Carcinoma subtypes > Squamous cell carcinoma


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