1
|
Santanelli di Pompeo F, Firmani G, Stanzani E, Clemens MW, Panagiotakos D, Di Napoli A, Sorotos M. Breast Implants and the Risk of Squamous Cell Carcinoma of the Breast: A Systematic Literature Review and Epidemiologic Study. Aesthet Surg J 2024; 44:757-768. [PMID: 38307034 DOI: 10.1093/asj/sjae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/12/2024] [Accepted: 01/19/2024] [Indexed: 02/04/2024] Open
Abstract
Squamous cell carcinoma may arise primarily from the breast parenchyma (PSCCB) or from the periprosthetic capsule in patients with breast implants (breast implant-associated squamous cell carcinoma [BIA-SCC]). A systematic literature review was performed to identify all PSCCB and BIA-SCC cases, and to estimate prevalence, incidence rate (IR), and risk. Studies up to November 2023 were searched on PubMed, Web of Science, Google Scholar, and Cochrane Library for predefined keywords. The numerator for PSCCB and BIA-SCC was the number of cases obtained from the literature; the denominator for PSCCB was the female population aged from 18 to 99, and the denominator for BIA-SCC was the population with breast implants. Overall, 219 papers were included, featuring 2250 PSCCB and 30 BIA-SCC cases. PSCCB prevalence was 2.0 per 100,000 (95% CI, 0.2:100,000 to 7.2:100,000) individuals, with a lifetime risk of 1:49,509 (95% CI, 0.2:10,000 to 5.6:10,000); and BIA-SCC prevalence was 0.61 per 100,000 (95% CI, 0.2:100,000 to 1.3:100,000), with a lifetime risk of 1:164,884 (95% CI, 0.2:100,000 to 5.6:100,000). The prevalence of BIA-SCC is 3.33 times lower than that of PSCCB, while the prevalence of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is 3.84 times higher than that of primary breast ALCL. When comparing the BIA-SCC prevalence of 1:164,910 individuals with breast implants regardless of texture to the BIA-ALCL prevalence of 1:914 patients with textured implants, the BIA-SCC risk is 180 times lower than the BIA-ALCL risk. BIA-SCC occurs less frequently than PSCCB and considerably less than BIA-ALCL. The association between textured implants and BIA-SCC cases is relevant for patient education regarding uncommon and rare risks associated with breast implants, and ongoing vigilance, research, and strengthened reporting systems remain imperative.
Collapse
|
2
|
Loving BA, Sivapalan S, Schukow CP, Khaira J, Vicini FA, Fontanesi J. Breast Conservation Therapy for Primary Squamous Cell Carcinoma of the Breast in an Elderly Woman: A Case Report. Cureus 2024; 16:e59447. [PMID: 38827005 PMCID: PMC11141109 DOI: 10.7759/cureus.59447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2024] [Indexed: 06/04/2024] Open
Abstract
This case report details a rare instance of primary squamous cell carcinoma (PSCC) of the breast in an octogenarian, emphasizing the unique diagnostic and treatment challenges posed by this malignancy in an elderly patient and adding to the scientific literature on PSCC managed with breast conservation therapy (BCT). An 80-year-old woman with medical comorbidities presented with a focal asymmetry in the right breast's retroareolar plane, detected during routine screening mammography. Diagnostic evaluations raised high suspicion for malignancy, confirmed as PSCC by ultrasound-guided biopsy. Histopathological analysis showed atypical keratinizing squamous epithelial nests and cysts. The patient underwent lumpectomy and re-excision of close surgical margins with a sentinel lymph node biopsy, which showed well-differentiated invasive squamous cell carcinoma with no residual carcinoma or nodal involvement. She was treated with adjuvant hypofractionated radiation therapy, experiencing minimal side effects. This case highlights the importance of considering individualized, nuanced approaches to adjuvant therapies in the treatment of PSCC in older patients. It demonstrates that BCT, coupled with carefully selected adjuvant therapy, can be a successful treatment strategy for PSCC in the elderly, contributing valuable insights into the management of this rare condition.
Collapse
Affiliation(s)
| | | | - Casey P Schukow
- Pathology, Corewell Health William Beaumont University Hospital, Royal Oak, USA
| | - Jashan Khaira
- Radiation Oncology, Oakland University William Beaumont School of Medicine, Rochester Hills, USA
| | | | - James Fontanesi
- Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, USA
| |
Collapse
|
3
|
Liu X, Chen J, Hou C. Primary squamous cell carcinoma of the breast: a case report. Discov Oncol 2024; 15:93. [PMID: 38558111 PMCID: PMC10984905 DOI: 10.1007/s12672-024-00958-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/28/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION Squamous cell carcinoma (SCC) of the breast is a rare variant of invasive breast cancer that has been classified as metaplastic carcinoma. When a tumor is composed of spindle cells, diagnosis is challenging. CASE REPORT A 42-year-old woman with a large mass in the right breast underwent modified radical mastectomy. A pathological examination revealed a tumor with central necrosis in it. The tumor had a sarcomatoid growth pattern and the cells were spindle-shaped with severe atypicality. Immunohistochemical staining showed that P63, P53, vimentin, and CKpan were positive, whereas estrogen receptor and C-erbB-2 were negative. Ki-67 proliferation index was as high as 90%. Therefore, a diagnosis of SCC of the right breast was made. The patient received eight cycles of postoperative chemotherapy with paclitaxel and carboplatin, followed by seven cycles of radiotherapy. During follow-up, the patient also had a left thyroid tumor, and postoperative pathology suggested microinvasive follicular carcinoma. Since breast surgery, the patient has remained disease-free for more than four years. CONCLUSION SCC of the breast with spindle cell and sarcomatoid features is rare. The diagnosis of such tumors requires exclusion of tumors with similar histological morphologies.
Collapse
Affiliation(s)
- Xibo Liu
- Department of Pathology, Shaoxing People's Hospital, No. 568, Zhongxing North Road, Shaoxing, 312000, Zhejiang, China
| | - Jiahui Chen
- Department of Pathology, Shaoxing People's Hospital, No. 568, Zhongxing North Road, Shaoxing, 312000, Zhejiang, China
| | - Chuanling Hou
- Department of Pathology, Shaoxing People's Hospital, No. 568, Zhongxing North Road, Shaoxing, 312000, Zhejiang, China.
| |
Collapse
|
4
|
Möllhoff N, Ehrl D, Fuchs B, Frank K, Alt V, Mayr D, Braig D, Giunta RE, Hagen C. [Breast implant-associated squamous cell carcinoma: a systematic literature review]. HANDCHIR MIKROCHIR P 2023; 55:268-277. [PMID: 37473774 DOI: 10.1055/a-2108-9111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Breast implant-associated squamous cell carcinoma (BIA-SCC) is being discussed as a distinct malignant tumour entity originating from the implant capsule. The FDA and the ASPS published a safety communication on BIA-SCC in 2022, with a first case report of BIA-SCC having been published in the 1990s. This manuscript summarises the current scientific data on this rare tumour entity. MATERIAL AND METHODS This systematic literature review from two independent databases includes all publications of cases with histopathologically confirmed BIA-SCC. Data extraction included study design, demographic data, implant information and details regarding diagnosis and treatment. RESULTS Nineteen cases of BIA-SCC with a mean age of 57±10 years were reported in 16 publications. In most cases, the indication was aesthetic augmentation (n=13). Both silicone (n=11) and saline (n=7) implants with different surfaces (smooth n=3, textured n=3, polyurethane n=1) were used. Symptoms such as unilateral swelling (n=18), pain (n=14) and erythema (n=5) occurred on an average of 23±9 years after implantation. Imaging showed fluid collection (n=8) or a tumour mass (n=4) around the breast implant. The most common surgical treatment was explantation with capsulectomy. Metastasis was described in 6 cases. CONCLUSIONS BIA-SCC is a malignant tumour entity associated with breast implant capsules. Based on current low-quality data (level of evidence class V), no definitive conclusion regarding correlation and causality of SCC in patients with breast implants can be drawn. There is an urgent need for national and international breast implant and breast cancer registries to obtain valid data on the incidence, pathogenesis and clinical presentation of rare tumour entities.
Collapse
Affiliation(s)
- Nicholas Möllhoff
- Abteilung für Hand-, Plastische- und Ästhetische Chirurgie, Klinikum der Universität München, LMU München, Deutschland
| | - Denis Ehrl
- Abteilung für Hand-, Plastische- und Ästhetische Chirurgie, Klinikum der Universität München, LMU München, Deutschland
| | - Benedikt Fuchs
- Abteilung für Hand-, Plastische- und Ästhetische Chirurgie, Klinikum der Universität München, LMU München, Deutschland
| | - Konstantin Frank
- Abteilung für Hand-, Plastische- und Ästhetische Chirurgie, Klinikum der Universität München, LMU München, Deutschland
- Ocean Clinic, Marbella, Spain
| | - Verena Alt
- Abteilung für Hand-, Plastische- und Ästhetische Chirurgie, Klinikum der Universität München, LMU München, Deutschland
| | - Doris Mayr
- Pathologisches Institut, Ludwig-Maximilians-Universität München, München, Deutschland
| | - David Braig
- Abteilung für Hand-, Plastische- und Ästhetische Chirurgie, Klinikum der Universität München, LMU München, Deutschland
- Klinik für Plastische und Handchirurgie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Deutschland
| | - Riccardo E Giunta
- Abteilung für Hand-, Plastische- und Ästhetische Chirurgie, Klinikum der Universität München, LMU München, Deutschland
| | - Christine Hagen
- Abteilung für Hand-, Plastische- und Ästhetische Chirurgie, Klinikum der Universität München, LMU München, Deutschland
| |
Collapse
|
5
|
Kinslow CJ, Yu JB, DeStephano DM, Kachnic LA, Cheng SK, Neugut AI, Horowitz DP. Risk of Squamous Cell Carcinoma of the Breast Following Postmastectomy Implant Reconstruction in Women With Breast Cancer and Carcinoma in Situ. JAMA Surg 2023; 158:769-771. [PMID: 37074722 PMCID: PMC10116379 DOI: 10.1001/jamasurg.2023.0262] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 01/17/2023] [Indexed: 04/20/2023]
Abstract
This cohort study uses national surveillance data to describe the incidence and risk of squamous cell carcinoma after postmastectomy implant reconstruction in women with breast cancer.
Collapse
Affiliation(s)
- Connor J. Kinslow
- Department of Radiation Oncology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - James B. Yu
- Department of Radiation Oncology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - David M. DeStephano
- Department of Radiation Oncology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Lisa A. Kachnic
- Department of Radiation Oncology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Simon K. Cheng
- Department of Radiation Oncology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Alfred I. Neugut
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - David P. Horowitz
- Department of Radiation Oncology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| |
Collapse
|
6
|
Kim YH, Park DW, Song KY, Lim HG, Jeong JP, Kim JH. Use of High-Resolution Ultrasound in Characterizing the Surface Topography of a Breast Implant. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1092. [PMID: 37374297 DOI: 10.3390/medicina59061092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 05/19/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: With the emergence of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), it has become necessary to identify the implant shell type patients have received. Therefore, an immediate, reliable method for identifying a breast implant shell type is essential. Evidence-based research and applying a real-world technique that identifies the surface topographic information of the inserted breast implants, without surgery, has become of paramount importance for breast implant physicians. Methods and Materials: A review of the medical records of 1901 patients who received 3802 breast implants and subsequently received an ultrasound-assisted examination was performed. All patients received not only a breast cancer examination but also a high-resolution ultrasonography (HRUS) assisted examination of the device at a single center between 31 August 2017 and 31 December 2022. Results: Most patients had breast implants within 10 years (77.7%) of the examination. Of the 3802 implants screened, 2034 (53.5%) were identified with macro-textured shell topography in ultrasonography. A macrotextured shell type implant was used in 53.5% of cases and a smooth type in 42.7% of cases. Seventy-three (1.9%) breast implant shell types could not be identified due to ruptures. However, 250 breast implant shell types could be identified despite rupture cases (6.5%). Conclusions: HRUS was found to be a useful and reliable image modality for identifying various surface shell types of breast implants. The shell type information would be helpful to patients who lack information about their breast implants and are concerned about BIA-ALCL.
Collapse
Affiliation(s)
- Yang-Hee Kim
- Department of Surgery, Kangwon National University, Chuncheon 24289, Republic of Korea
| | | | - Keun-Yeong Song
- Department of Breast Surgery, Gwangju Suwan Hospital, Gwangju 62247, Republic of Korea
| | - Hyung-Guhn Lim
- Department of Radiology, Gwangju Suwan Hospital, Gwangju 62247, Republic of Korea
| | | | | |
Collapse
|
7
|
Vorstenbosch J, Chu JJ, Ariyan CE, McCarthy CM, Disa JJ, Nelson JA. Clinical Implications and Management of Non-BIA-ALCL Breast Implant Capsular Pathology. Plast Reconstr Surg 2023; 151:20e-30e. [PMID: 36194076 PMCID: PMC9797444 DOI: 10.1097/prs.0000000000009780] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
SUMMARY The breast implant capsule is a dynamic structure that forms following the implantation of a device. Although normally benign, increased awareness of breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) highlights that disease may arise from the capsule. BIA-ALCL presents as a late seroma or mass but explains few of the late seromas found in breast implant patients. To date, many of these seromas lack a clear cause and are often described as "idiopathic." Several benign and malignant breast implant capsular diseases can cause a late seroma or mass, including breast implant-associated squamous cell carcinoma. Similar to early reports of BIA-ALCL, these conditions are rare and largely limited to case reports or series. The purpose of this special topic is to present a narrative review highlighting capsular abnormalities that contribute to the formation of late seroma or mass in an attempt to broaden the differential diagnosis and help plastic surgeons identify the cause. Specifically, we review the presentation and management of BIA-ALCL, synovial metaplasia, capsular epithelialization, late hematoma, double capsule, breast cancer, squamous cell carcinoma, mesenchymal tumor, and B-cell lymphoma. Although rare, plastic surgeons should consider these capsular conditions as causes of late seromas and masses. Usually, these conditions may be diagnosed by following the National Comprehensive Cancer Network screening guidelines for BIA-ALCL. Thorough evaluation and workup of late seromas and masses may lead to improved characterization of these rare breast implant capsular conditions and improve our understanding of their pathophysiology and management.
Collapse
Affiliation(s)
- Joshua Vorstenbosch
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jacqueline J. Chu
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Charlotte E. Ariyan
- Gastric and Mixed Tumor Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Colleen M. McCarthy
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Joseph J. Disa
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jonas A. Nelson
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| |
Collapse
|
8
|
Song Q, Yang Y, Jiang D, Qin Z, Xu C, Wang H, Huang J, Chen L, Luo R, Zhang X, Huang Y, Xu L, Yu Z, Tan S, Deng M, Xue R, Qie J, Li K, Yin Y, Yue X, Sun X, Su J, He F, Ding C, Hou Y. Proteomic analysis reveals key differences between squamous cell carcinomas and adenocarcinomas across multiple tissues. Nat Commun 2022; 13:4167. [PMID: 35851595 PMCID: PMC9293992 DOI: 10.1038/s41467-022-31719-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 06/24/2022] [Indexed: 12/24/2022] Open
Abstract
Squamous cell carcinoma (SCC) and adenocarcinoma (AC) are two main histological subtypes of solid cancer; however, SCCs are derived from different organs with similar morphologies, and it is challenging to distinguish the origin of metastatic SCCs. Here we report a deep proteomic analysis of 333 SCCs of 17 organs and 69 ACs of 7 organs. Proteomic comparison between SCCs and ACs identifies distinguishable pivotal pathways and molecules in those pathways play consistent adverse or opposite prognostic roles in ACs and SCCs. A comparison between common and rare SCCs highlights lipid metabolism may reinforce the malignancy of rare SCCs. Proteomic clusters reveal anatomical features, and kinase-transcription factor networks indicate differential SCC characteristics, while immune subtyping reveals diverse tumor microenvironments across and within diagnoses and identified potential druggable targets. Furthermore, tumor-specific proteins provide candidates with differentially diagnostic values. This proteomics architecture represents a public resource for researchers seeking a better understanding of SCCs and ACs. Squamous cell carcinomas are an aggressive cancer type which can occur in multiple organ systems. Here, the authors analyse the proteome of SCC cancers from 17 organs and show commonly dysregulated proteins independent of location.
Collapse
Affiliation(s)
- Qi Song
- Department of Pathology, Zhongshan Hospital, State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Ye Yang
- Department of Pathology, Zhongshan Hospital, State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Dongxian Jiang
- Department of Pathology, Zhongshan Hospital, State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Zhaoyu Qin
- Department of Pathology, Zhongshan Hospital, State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Chen Xu
- Department of Pathology, Zhongshan Hospital, State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Haixing Wang
- Department of Pathology, Zhongshan Hospital, State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Jie Huang
- Department of Pathology, Zhongshan Hospital, State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Lingli Chen
- Department of Pathology, Zhongshan Hospital, State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Rongkui Luo
- Department of Pathology, Zhongshan Hospital, State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Xiaolei Zhang
- Department of Pathology, Zhongshan Hospital, State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Yufeng Huang
- Department of Pathology, Zhongshan Hospital, State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Lei Xu
- Department of Pathology, Zhongshan Hospital, State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Zixiang Yu
- Department of Pathology, Zhongshan Hospital, State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Subei Tan
- Department of Pathology, Zhongshan Hospital, State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Minying Deng
- Department of Pathology, Zhongshan Hospital, State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Ruqun Xue
- Department of Pathology, Zhongshan Hospital, State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Jingbo Qie
- Department of Pathology, Zhongshan Hospital, State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Kai Li
- Department of Pathology, Zhongshan Hospital, State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Yanan Yin
- Department of Pathology, Zhongshan Hospital, State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Xuetong Yue
- Department of Pathology, Zhongshan Hospital, State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Xiaogang Sun
- State Key Laboratory Cell Differentiation and Regulation, Overseas Expertise Introduction Center for Discipline Innovation of Pulmonary Fibrosis, (111 Project), College of Life Science, Henan Normal University, Xinxiang, Henan, China
| | - Jieakesu Su
- Department of Pathology, Zhongshan Hospital, State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Fuchu He
- State Key Laboratory of Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences (Beijing), Beijing Institute of Lifeomics, Beijing, China.
| | - Chen Ding
- Department of Pathology, Zhongshan Hospital, State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Fudan University, Shanghai, China. .,State Key Laboratory Cell Differentiation and Regulation, Overseas Expertise Introduction Center for Discipline Innovation of Pulmonary Fibrosis, (111 Project), College of Life Science, Henan Normal University, Xinxiang, Henan, China. .,Academy of Medical Science, Zhengzhou University, Zhengzhou, China.
| | - Yingyong Hou
- Department of Pathology, Zhongshan Hospital, State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Fudan University, Shanghai, China.
| |
Collapse
|
9
|
Tejera Hernández AA, Vega Benítez VM, Pavcovich Ruiz M, Hernández Hernández JR. Metaplastic carcinoma of the breast with squamous differentiation: prognostic factors and multidisciplinary treatment. World J Surg Oncol 2022; 20:187. [PMID: 35676703 PMCID: PMC9178843 DOI: 10.1186/s12957-022-02656-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 03/19/2022] [Indexed: 01/17/2023] Open
Abstract
Background The objective of this study was to analyze the characteristics of patients diagnosed with metaplastic carcinoma of the breast with squamous differentiation and to identify the particular clinical and histological characteristics that need to be taken into account in this type of tumors. Case presentation Retrospective observational study of two patients managed at our hospital between 2014 and 2020 (15 months mean follow-up), plus all cases published in the last 7 years (8 patients). Thus, a total of 10 cases were analyzed, all with less than 2 years mean global survival. Studied variables were: age, medical background, tumor size, axillary involvement, radiological characteristics, surgical approach, complementary treatments, histologic characteristics, and progression of the disease. In 50% of cases, the disease appeared as a palpable mass of rapid growth, associated with axillary infiltration; 80% of the tumors were triple negative; 30% of them progressed to distant metastatic disease in 30%. Conclusions This unusual carcinoma requires a complex multidisciplinary treatment. Its prognosis is unfavorable due to its high local aggressiveness, with rapid progression and appearance of metastatic disease. The predominance of different histological components may determine the response to medical treatments.
Collapse
Affiliation(s)
- Ana Alicia Tejera Hernández
- Faculty of Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain. .,General Surgery Department, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas, Spain.
| | - Víctor Manuel Vega Benítez
- Faculty of Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain.,General Surgery Department, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas, Spain
| | - Marta Pavcovich Ruiz
- Faculty of Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain.,Department of Pathology, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas, Spain
| | - Juan Ramón Hernández Hernández
- Faculty of Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain.,General Surgery Department, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas, Spain
| |
Collapse
|
10
|
Varughese B, Sharif SZ, Yee HK, Sahid Nik Lah NA. A rare case of breast squamous cell carcinoma and literature review. Ann Med Surg (Lond) 2022; 78:103825. [PMID: 35734729 PMCID: PMC9206937 DOI: 10.1016/j.amsu.2022.103825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/15/2022] [Accepted: 05/16/2022] [Indexed: 11/03/2022] Open
Abstract
Introduction Presentation of case Discussion Conclusion Breast Squamous Cell Carcinoma (SCC) is quite a rare tumour that the features portray squamous cell differentiation. This case highlights the need of early detection along with the obstacles faced in reaching an early diagnosis. The prognosis usually depends on the tumour size and the advance age of the patient.
Collapse
|
11
|
Noro A, Ishitobi M, Hanamura N, Kashikura Y, Yamashita M, Kozuka Y, Saito K, Mizuno T, Ogawa T. A Case of Metaplastic Squamous Cell Carcinoma of the Breast that Showed a Pathological Complete Response After Neoadjuvant Chemotherapy with Weekly Paclitaxel. Am J Case Rep 2022; 23:e935035. [PMID: 35017459 PMCID: PMC8765086 DOI: 10.12659/ajcr.935035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Patient: Female, 40-year-old
Final Diagnosis: Squamous cell carcinoma of the breast
Symptoms: A palpable tumor of the right breast
Medication: —
Clinical Procedure: Core needle biopsy
Specialty: Oncology
Collapse
Affiliation(s)
- Aya Noro
- Department of Breast Surgery, Mie Prefectural General Medical Center, Yokkaichi, Mie, Japan.,Department of Breast Surgery, Mie University Hospital, Tsu, Mie, Japan
| | - Makoto Ishitobi
- Department of Breast Surgery, Mie University Hospital, Tsu, Mie, Japan
| | - Noriko Hanamura
- Department of Breast Surgery, Saiseikai Matsusaka General Hospital, Matsusaka, Mie, Japan
| | - Yumi Kashikura
- Breast Surgery, Saiseikai Matsusaka General Hospital, Matsusaka, Mie, Japan
| | - Masako Yamashita
- Department of Breast Surgery, Mie Prefectural General Medical Center, Yokkaichi, Mie, Japan
| | - Yuji Kozuka
- Department of Pathology, Mie University Hospital, Tsu, Mie, Japan
| | - Kanako Saito
- Medical Oncology, Mie University Hospital, Tsu, Mie, Japan
| | - Toshiro Mizuno
- Department of Medical Oncology, Mie University Hospital, Tsu, Mie, Japan
| | - Tomoko Ogawa
- Department of Breast Surgery, Mie University Hospital, Tsu, Mie, Japan
| |
Collapse
|
12
|
Lumpectomy Combined with Adjuvant Radiotherapy Could Be a Treatment Option for Primary Squamous Cell Carcinoma of the Breast. JOURNAL OF ONCOLOGY 2021; 2021:2497227. [PMID: 34899904 PMCID: PMC8660218 DOI: 10.1155/2021/2497227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/27/2021] [Accepted: 11/12/2021] [Indexed: 11/18/2022]
Abstract
Background To investigate the outcomes of primary squamous cell carcinoma (PSCC) of the breast undergoing radical surgery with or without adjuvant radiotherapy (RT). Materials and Methods A population cohort with histologically diagnosed PSCC of the breast was identified from the SEER database. The Kaplan-Meier method and Cox-regression proportional hazards model was used to assess the impact of surgical types with or without adjuvant RT on the cause-specific survival (CSS) and overall survival (OS). A retrospective analysis of PSCC between Jan 2010 and Dec 2018 from our institute was performed. Results A total of 515 patients with PSCC of the breast were included, 254 patients treated with mastectomy (MAST) alone, 78 with MAST + RT, 87 with lumpectomy (LUMP) alone, and 96 with LUMP + RT. The median follow-up time was 118 months (range: 0-379 months). In the multivariate Cox analyses, LUMP + adjuvant RT was an independent prognostic factor for CSS (p = 0.028) and OS (p = 0.048). Patients treated with LUMP + RT had better survival rates than patients who underwent lumpectomy (CSS, p = 0.034; OS, p = 0.0004), MAST alone (CSS, p = 0.0001; OS, p < 0.0001), and MAST + RT (CSS, p = 0.0001; OS, p = 0.0078), while postmastectomy RT did not significantly improve OS (p = 0.062) and CSS (p = 0.67) when compared to MAST alone. In addition, a total of 28 patients with PSCC of the breast were identified from our institute. All of these patients presented with estrogen receptor-negative type, and three of them had HER-2-positive PSCC; the median tumor size was 3 cm (range: 0.5-15 cm). Eight patients were treated with LUMP + adjuvant RT, thirteen with MAST, and seven with MAST + RT. Until the last follow-up of Sep 2021, 26 patients with PSCC were still alive and free of breast cancer, excepting that one patient treated with MAST and one patient with MAST + RT died from breast cancer. Conclusion PSCC of the breast after radical surgery has a poor prognosis. Adjuvant RT after LUMP significantly improves survival of patients with PSCC of the breast. Further studies are still needed to investigate the role of adjuvant RT in PSCC of the breast after mastectomy.
Collapse
|
13
|
Han Y, Wang J, Wang Z, Xu B. Clinicopathological Characteristics and Prognosis of Squamous Cell Carcinoma of the Breast: A Population-Based Analysis. Cancer Control 2021; 28:10732748211044355. [PMID: 34654324 PMCID: PMC8521731 DOI: 10.1177/10732748211044355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background To better understand the clinicopathological features and prognostic profiles of squamous cell carcinoma (SCC) of the breast. Methods Information on breast cancer was obtained from the Surveillance, Epidemiology, and End Results database (2004–2016). Comparative analyses were carried out to investigate the heterogeneity in the clinicopathological characteristics and survival outcomes between SCC and invasive ductal carcinoma (IDC), while propensity score matching was conducted to analyze the variations among baseline characteristics. Prognostic factors for SCC of the breast were successively identified using Cox regression analysis. Results A total of 382 SCC patients and 561477 IDC patients were identified in this study. Comparatively, the SCC cohort exhibited a higher proportion of male individuals, poor differentiation, an advanced TNM stage, an increasing percentage of triple-negative (TN) subtype, an increasing rate of organ involvement, and less access to therapeutics. The aggressive profile was consistent in the TN subgroup, with a significantly higher proportion in SCC than in IDC (25.7% vs 6.8%). Prognosis of SCC was profoundly poorer than that of IDC (mOS, 78.6 months and 121.6 months, P < .0001; mBCSS 91.9 months vs 135.6 months, P < .0001), of which the inferior tendency remained stable among disease stage and therapeutic options, while no difference was detected in the 2 subgroups with the TN subtype. The 2-year survival rate was 66.9% and the 5-year survival rate was 51.4%, with the risk factors being older age, bilateral disease, advanced TNM stage, bone and visceral involvement, surgical intervention, radiation treatment, and chemotherapy. Conclusions This study systematically analyzed the heterogeneous characteristics of SCC of the breast in comparison with IDC. Squamous cell breast cancer presented with increasing aggressive behavior and inferior prognosis. Prospective studies should focus on this subgroup and introduce individualized therapeutic protocols in clinical practice.
Collapse
Affiliation(s)
- Yiqun Han
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiayu Wang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zijing Wang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Binghe Xu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
14
|
Chao X, Tan W, Tsang JY, Tse GM, Hu J, Li P, Hou J, Li M, He J, Sun P. Clinicopathologic and genetic features of metaplastic breast cancer with osseous differentiation: a series of 6 cases. Breast Cancer 2021; 28:1100-1111. [PMID: 33942253 DOI: 10.1007/s12282-021-01246-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 04/01/2021] [Indexed: 01/12/2023]
Abstract
AIMS Metaplastic breast cancer (MBC) comprises a heterogeneous group of tumors, of which MBC with osseous differentiation (MBC-OD) is extremely rare that only few cases have been reported. This study aimed to present the clinicopathologic and molecular features of MBC-OD. METHODS We collected 6 cases of MBC-OD from five different centers and described its clinicopathologic and molecular characteristics based on the next-generation sequencing. Another 11 cases from the literature were also reviewed to better characterize the tumor. RESULTS The tumor primarily showed an osteosarcoma-like appearance, which composed of high cellularity with spindle cells and osteoblast-like cells producing coarse lace-like neoplastic bone (4/6) or osteoid matrix (6/6). 55 somatic mutations including 39 missenses (70.9%), 9 frameshifts (16.4%), 3 splice sites (5.5%), 3 in-frame InDels (5.5%) and 1 nonsense (1.8%) were identified. TP53 was the most frequently mutated genes (5/6, 83.3%), followed by RB1 (3/6, 50.0%), BCOR (2/6, 33.3%), MED12 (2/6, 33.3%), PIK3CA (2/6, 33.3%), and TET2 (2/6, 33.3%). Genetic alterations suggesting therapies with clinical benefit, including mTOR inhibitors, tyrosine kinase inhibitors (TKI), and poly-ADP ribose polymerase inhibitor (PARPi), were observed in five cases. The median follow-up was 21 months (range, 3-80 months). Local recurrence was observed in two cases and three patients displayed distant metastasis. Two patients died of the disease at 3 months and 7 months, respectively. CONCLUSIONS Based on this series, MBC-OD is a highly aggressive breast tumor with osteosarcoma-like morphology and a high incidence of recurrent disease showing specific genetic profiles.
Collapse
Affiliation(s)
- Xue Chao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Pathology, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, 510080, Guangzhou, People's Republic of China
| | - Wanlin Tan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Pathology, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, 510080, Guangzhou, People's Republic of China
| | - Julia Y Tsang
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Gary M Tse
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Jintao Hu
- Department of Pathology, The Second Clinical Medical College, Shenzhen People's Hospital, Jinan University, Shenzhen, China
| | - Ping Li
- Department of Pathology, Shenzhen Hospital of Peking University, Shenzhen, China
| | - Jinghui Hou
- Department of Pathology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Mei Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Pathology, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, 510080, Guangzhou, People's Republic of China
| | - Jiehua He
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China. .,Department of Pathology, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, 510080, Guangzhou, People's Republic of China.
| | - Peng Sun
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China. .,Department of Pathology, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, 510080, Guangzhou, People's Republic of China.
| |
Collapse
|
15
|
Shrestha S, Shakya P, Kharel S, Dhakal HP, Singh M, Shrestha AK. Primary squamous cell carcinoma of the breast in a young female- A rare ailment. Clin Case Rep 2021; 9:e04214. [PMID: 34084512 PMCID: PMC8142402 DOI: 10.1002/ccr3.4214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/03/2021] [Accepted: 04/11/2021] [Indexed: 11/24/2022] Open
Abstract
Primary squamous cell carcinoma of the breast is an extremely rare invasive breast carcinoma with rapid progression and worse prognosis. Careful assessment and diagnosis of the entity should also be considered in a rapidly progressing breast tumor.
Collapse
Affiliation(s)
- Suraj Shrestha
- Maharajgunj Medical CampusInstitute of MedicineKathmanduNepal
| | - Prafulla Shakya
- Department of SurgeryNepal Cancer Hospital and Research CenterLalitpurNepal
| | - Sanjeev Kharel
- Maharajgunj Medical CampusInstitute of MedicineKathmanduNepal
| | - Hari Prasad Dhakal
- Department of PathologyNepal Cancer Hospital and Research CenterLalitpurNepal
| | - Moushami Singh
- Department of PathologyNepal Cancer Hospital and Research CenterLalitpurNepal
| | | |
Collapse
|
16
|
Lei T, Pu T, Wei B, Fan Y, Yang L, Shen M, Chen M, Yang J, Zhang Y, Zhang Z, Bu H. Clinicopathologic characteristics of HER2-positive metaplastic squamous cell carcinoma of the breast. J Clin Pathol 2020; 75:18-23. [PMID: 33214199 DOI: 10.1136/jclinpath-2020-206468] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 08/18/2020] [Accepted: 10/01/2020] [Indexed: 02/05/2023]
Abstract
AIMS The aim of this study was to analyse the clinicopathological features and prognosis of human epidermal growth factor receptor-2 (HER2)-positive metaplastic squamous cell carcinoma (MSCC). METHODS Fifty-eight patients with MSCC of the breast who were classified into 45 triple-negative and 13 HER2-positive subgroups diagnosed at the West China Hospital, Sichuan University, from 2004 to 2018, were enrolled. Clinicopathological features were collected and compared between HER2-positive MSCC, triple-negative MSCC, HER2-positive invasive breast carcinoma of no special type (NST) and triple-negative NST groups. In the prognostic survival analysis, HER2-positive MSCCs was compared with triple-negative MSCCs, HER2-positive NSTs and triple-negative NSTs. RESULTS Compared with triple-negative MSCCs, more patients with Ki-67 low expression were in HER2-positive MSCCs (p<0.05). More patients with HER2-positive MSCC than patients with HER2-positive NST were postmenopausal (p<0.05). Compared among HER2-positive MSCCs, triple-negative MSCCs and triple-negative NSTs, patients of HER2-positive MSCCs with high Ki-67 expression were the least, and HER2-positive MSCCs had more strongly associated with postmenopausal disease status (p<0.05). In survival analyses, HER2-positive MSCCs had a high risk of recurrence and poor prognosis (p<0.05). Lymph node status was significantly associated with the disease-free survival of patients with HER2-positive MSCC. CONCLUSION In conclusion, our study indicates that HER2-positive MSCC is an aggressive disease with unique clinicopathological characteristics. Both HER2-positive status and an SCC component are critical factors for poor prognosis. HER2-positive MSCC and triple-negative MSCC are distinct subgroups. Corresponding targeted therapy recommendations should be made for this HER2-positive MSCC group.
Collapse
Affiliation(s)
- Ting Lei
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Laboratory of Pathology, Key Laboratory of Transplant Engineering and Immunology, NHFPC, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Tianjie Pu
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Laboratory of Pathology, Key Laboratory of Transplant Engineering and Immunology, NHFPC, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bing Wei
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yingying Fan
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Libo Yang
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Laboratory of Pathology, Key Laboratory of Transplant Engineering and Immunology, NHFPC, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Mengjia Shen
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Laboratory of Pathology, Key Laboratory of Transplant Engineering and Immunology, NHFPC, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Min Chen
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jieliang Yang
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yu Zhang
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhang Zhang
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hong Bu
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Laboratory of Pathology, Key Laboratory of Transplant Engineering and Immunology, NHFPC, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
17
|
Wang X, Zhang L, Luo J, Jin K, Yang Z, Meng J, Zhang X, Zhang Z, Shao Z, Guo X, Chen X, Yu X. Postoperative radiotherapy improves overall survival in patients with primary squamous cell carcinoma of the breast. Asia Pac J Clin Oncol 2020; 17:454-461. [PMID: 33079490 DOI: 10.1111/ajco.13466] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 09/05/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Primary squamous cell carcinoma of the breast (PSCCB) is a rare clinical classification of breast tumors. Little is known about its clinicopathological features, prognosis and potential therapeutic strategies. The purpose of this study is to evaluate the effect of postoperative radiotherapy (PORT) on patients with squamous cell carcinoma (SCC) of the breast. METHODS We retrospectively analyzed patients diagnosed with PSCCB in our center. All pathological slides were reviewed by an experienced pathologist to confirm the diagnosis. Furthermore, we searched the public database for patients with SCC of the breast. Then, we analyzed the clinicopathological features, treatment methods and patient outcomes. RESULTS We identified 14 patients with primary SCC of the breast in our center. Additionally, 739 patients with SCC of the breast from the Surveillance, Epidemiology and End Results (SEER) database were diagnosed between 1975 and 2016. Only 453 patients who underwent surgery were included in this study. Patients from the SEER database had a more advanced tumor node metastasis (TNM) stage than patients from our center. The median overall survival (OS) of all patients was 104 months (95% confidence interval [CI], 87.2-120.8 months), and the 5-year OS was 60.8% (95% CI, 56.1%-65.5%). Most of the patients (58%) tested negative for hormonal receptor expression. Multivariate analysis showed that PORT was an independent prognostic factor for OS. CONCLUSION The results of our study demonstrate that SCC of the breast presents aggressive behavior with unique clinical characteristics. PORT improved OS significantly in patients with SCC of the breast. Longer-term studies are needed to confirm our findings.
Collapse
Affiliation(s)
- Xuanyi Wang
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, Shanghai, China
| | - Li Zhang
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, Shanghai, China
| | - Jurui Luo
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, Shanghai, China
| | - Kairui Jin
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, Shanghai, China
| | - Zhaozhi Yang
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, Shanghai, China
| | - Jin Meng
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, Shanghai, China
| | - Xiaomeng Zhang
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, Shanghai, China
| | - Zhen Zhang
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, Shanghai, China
| | - Zhimin Shao
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, Shanghai, China.,Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, Shanghai, China
| | - Xiaomao Guo
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, Shanghai, China
| | - Xingxing Chen
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, Shanghai, China
| | - Xiaoli Yu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, Shanghai, China
| |
Collapse
|
18
|
Kashu N, Oura S, Yoshida H, Nishino E, Makimoto S. A Case of Squamous Cell Carcinoma of the Breast with Low-Grade Adenosquamous Carcinoma. Case Rep Oncol 2020; 13:1152-1157. [PMID: 33173478 PMCID: PMC7590783 DOI: 10.1159/000508181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 04/24/2020] [Indexed: 01/31/2023] Open
Abstract
A 68-year-old woman with a breast mass was referred to our hospital. Imaging studies showed an oval well-defined mass, 1.3 cm in size, in her left lower outer quadrant of the breast. Core needle biopsy with immunohistochemical staining showed atypical spindle cells forming solid nests with necrosis and papillary lesions, leading to the tentative and pre-operative diagnosis of invasive ductal carcinoma. Due to the absence of daughter nodules, extensive ductal spread, and lymphadenopathy on imaging evaluation, the patient underwent breast-conserving surgery and sentinel node biopsy, resulting in negative surgical margins and no lymph node involvement. Post-operative pathological examination showed triple negative atypical cells with squamous differentiation, squamous cell carcinoma (SCC), with cystic parts and a small amount of low-grade adenosquamous cell carcinoma (LGASC), both encompassing the cystic parts in a contiguous fashion. No cases with synchronous SCC and LGASC in the breast have been reported to date. An etiologic correlation between SCC and LGASC should be further evaluated.
Collapse
Affiliation(s)
- Nozomi Kashu
- Department of Surgery, Kishiwada Tokushukai Hospital, Kishiwada, Japan
| | - Shoji Oura
- Division of Breast Surgery, Kishiwada Tokushukai Hospital, Kishiwada, Japan
| | | | - Eisei Nishino
- Division of Pathology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
| | | |
Collapse
|
19
|
Han Y, Wang J, Xu B. Clinicopathological characteristics and prognosis of breast cancer with special histological types: A surveillance, epidemiology, and end results database analysis. Breast 2020; 54:114-120. [PMID: 32979771 PMCID: PMC7519362 DOI: 10.1016/j.breast.2020.09.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 02/07/2023] Open
Abstract
Objectives To explore the clinicopathological features and prognosis of breast cancer with special histological types. Materials and methods The information of breast cancer patients was obtained from the Surveillance, Epidemiology, and End Results (SEER) database (2010–2016). Comparative analyses were performed to explore the difference in clinicopathological characteristics and propensity score matching (PSM) was used to weaken the effects from clinical profiles. Survival analysis was conducted to investigate the prognostic effects from histological types, and the prognostic factors of this group of patients were identified with the univariate COX proportional model. Results A total of 242863 breast cancer patients were eligible, of which 230213 individuals were ductal breast cancer (IDC) and 12650 individuals were special breast lesions, respectively. Comparatively, special breast cancer had a lower histological grade, a smaller tumor size, a lower proportion of nodal involvement and distant metastasis, in addition to a higher proportion of triple-negative subtype. The overall prognosis of special histological breast cancer was comparable to IDC, while the survival of HER2 enriched breast cancer was in favor of special breast cancer. With the PSM performance, the prognosis exhibited an inferior profile in the metaplastic breast cancer and was significantly favorable to apocrine, medullary, micropapillary, and papillary breast cancer. Conclusion This study revealed that the special histological breast cancer presented distinct clinicopathological characteristics and great heterogeneity in the prognosis among diverse histological subtypes. Breast cancer is a heterogenous disease with diverse histological subtypes. Special histological breast cancer exhibits distinct clinicopathological profiles. Prognosis of special histological breast cancer is profoundly heterogenous. Histological subtype is an independent prognostic indicator of breast cancer.
Collapse
Affiliation(s)
- Yiqun Han
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Jiayu Wang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China.
| | - Binghe Xu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China.
| |
Collapse
|
20
|
Kuwahara M, Yurugi S, Ando J, Takeuchi M, Miyata R, Harada M, Masuda Y, Kanagawa S. Squamous cell carcinoma developed in a chronic radiation-induced chest wall ulcer that is difficult to undergo thorough preoperative histological examination. Int J Surg Case Rep 2020; 72:467-470. [PMID: 32698267 PMCID: PMC7317167 DOI: 10.1016/j.ijscr.2020.05.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/24/2020] [Accepted: 05/25/2020] [Indexed: 11/17/2022] Open
Abstract
Squamous cell carcinoma (SCC) arose in a large chronic radiation-induced thoracic ulcer which exposing the lung and pericardium after flap surgery. Preoperative histopathological examination point indicated Inflammation. But after flap surgery, squamous cell carcinoma was diagnosed from a fistula at the margin of the flap. We should have asked a thoracic/cardiac surgeon to conduct a biopsy at the pericardium during the debridement operation before flap covering. It is necessary to consider the best method for performing the most thorough histological examination possible, even in areas where histological examinations are difficult, as all ulcers can contain tumors.
Introduction We report a case in which squamous cell carcinoma (SCC) developed in a large chronic radiation-induced thoracic ulcer after flap surgery in areas where preoperative histological examinations are difficult. Presentation of case The patient was a 75-year-old female. She had undergone resection and radiotherapy for left breast cancer 15 years earlier. Six years ago, the ulcer expanded from the subclavian to xiphoid levels, exposing the lung and pericardium. A histopathological examination, which avoided the lung and pericardium, was performed. Inflammation was diagnosed. We reconstructed the chest wall with a pedicled rectus abdominis flap. Eighteen months later, three verrucous tissue-lined fistulas formed. A histological examination revealed well-differentiated SCC. Six months later, the patient died of massive bleeding from a fistula. Discussion It is unclear exactly when the SCC occurred. As three fistulas formed at the margins of the flap around the pericardium, we suspect that the cancer developed within or near the pericardial region. We need to reflect on the lack of a thorough biopsy. As no pericardial biopsy was performed, we should have asked a thoracic/cardiac surgeon to conduct a biopsy during the debridement operation. If the tumor had been localized to the pericardium, it could have been removed. Conclusion It is necessary to consider the best method for performing the most thorough histological examination possible, even in areas where histological examinations are difficult, as all ulcers can contain tumors.
Collapse
Affiliation(s)
- Masamitsu Kuwahara
- Division of Plastic Surgery, Nara Medical University Hospital, 840 Shijocho, Kashihara, Nara 634-8522, Japan.
| | - Satoshi Yurugi
- Division of Plastic Surgery, Nara Medical University Hospital, 840 Shijocho, Kashihara, Nara 634-8522, Japan
| | - Junji Ando
- Division of Plastic Surgery, Nara Medical University Hospital, 840 Shijocho, Kashihara, Nara 634-8522, Japan
| | - Mika Takeuchi
- Division of Plastic Surgery, Nara Medical University Hospital, 840 Shijocho, Kashihara, Nara 634-8522, Japan
| | - Riyo Miyata
- Division of Plastic Surgery, Nara Medical University Hospital, 840 Shijocho, Kashihara, Nara 634-8522, Japan
| | - Masayuki Harada
- Division of Plastic Surgery, Nara Medical University Hospital, 840 Shijocho, Kashihara, Nara 634-8522, Japan
| | - Yasumitsu Masuda
- Division of Plastic Surgery, Nara Medical University Hospital, 840 Shijocho, Kashihara, Nara 634-8522, Japan
| | - Saori Kanagawa
- Division of Plastic Surgery, Nara Medical University Hospital, 840 Shijocho, Kashihara, Nara 634-8522, Japan
| |
Collapse
|
21
|
Zhu L, Chen K. Clinicopathological features, treatment patterns, and prognosis of squamous cell carcinoma of the breast: an NCDB analysis. BMC Cancer 2019; 19:26. [PMID: 30621628 PMCID: PMC6323666 DOI: 10.1186/s12885-018-5212-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 12/12/2018] [Indexed: 11/23/2022] Open
Abstract
Background Squamous cell carcinoma (SCC) of the breast is a rare malignancy. The clinicopathological features, treatment patterns and prognosis of SCC of the breast is still unclear. Methods In this study, we performed a 1:4 SCC-IDC (infiltrating ductal carcinoma) matching analysis of patients diagnosed between 2004 and 2014, using the data from the national cancer database. We used Chi-square test to compare the clinicopathological features and treatment patterns between SCC (n = 686) and IDC (n = 2744) patients. We used Kaplan-Meier analysis and Cox-regression to estimate the survival of SCC and IDC patients. Results We observed that SCC patients are more likely to have T3–4, grade III, and ER negative diseases, when compared to IDC patients. Breast conserving surgery (BCS) (58.3% vs 65.4%, p = 0.048), as well as radiotherapy after BCS (65.3% vs. 83.0%, p < 0.001), was less performed in SCC patients. Among low-risk patients, chemotherapy was used more often for SCC patients (42.9%) than for IDC (18.7%) patients (p = 0.002). In HR-positive patients, endocrine therapy was used less often for SCC patients (51.6%) than for IDC patients (70.5%) (p < 0.001). SCC (vs. IDC) was associated with no responses to neoadjuvant chemotherapy (20% vs. 5.05%, p = 0.019). Adjusted analysis confirmed that SCC (vs. IDC) was associated with worse OS (HR = 1.40, 95%CI 1.17–1.67, P < 0.01), after a median follow-up of 58.3 months. In SCC patients, HR status is not prognostic of OS, but endocrine therapy was significantly associated with improved OS in HR-positive SCC patients. Conclusions We conclude that SCC is associated with poorer clinicopathological features, no responses to neoadjuvant chemotherapy and worse clinical outcomes than IDC. The treatment patterns for SCC and IDC are different. Endocrine therapy is necessary for HR-positive SCC patients. Electronic supplementary material The online version of this article (10.1186/s12885-018-5212-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Liling Zhu
- Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West. Road, Guangzhou, 510120, People's Republic of China. .,Department of Biostatistics, School of Public Health, Yale University, 300 George Suit 503, New Haven, CT, 06511, USA.
| | - Kai Chen
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China. .,Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West. Road, Guangzhou, 510120, People's Republic of China.
| |
Collapse
|
22
|
Abstract
Breast augmentation is the most common cosmetic surgery in the United States. Squamous cell carcinoma (SCC) of the breast raises suspicion of possibly metastatic origin. Here, we report an unusual case of implant-associated SCC of the breast post silicone gel breast implant. The patient is a 46-year-old female with SCC of the breast. She initially had silicone gel breast implantation for breast augmentation in 1995. She had multiple revisions due to swelling and hardening. In 2016, she underwent bilateral prosthesis explantation and bilateral capsulectomy. The pathology demonstrated a 4-cm tumor that was moderately differentiated invasive SCC. On slide review, it was noted that there was squamous epithelization of the implant capsule with benign squamous epithelium on both sides. She received external beam radiation to the right breast; no adjuvant chemotherapy was offered due to the rare histology and paucity of data. Follow-up within a year showed metastasis to the liver, lungs and retroperitoneum. She was admitted and ultimately transferred from the medical intensive care unit to the palliative care unit for comfort care. She expired of her disease in July 2017.
Collapse
Affiliation(s)
- Yu M Zhou
- Radiation Oncology, University of Cincinnati College of Medicine, Cincinnati, USA
| | - Huma E Chaudhry
- Radiation Oncology, Hofstra Northwell School of Medicine, Hempstead, USA
| | - Amar Shah
- Radiology, Hofstra Northwell School of Medicine, Hempstead, USA
| | - Janna Andrews
- Radiation Oncology, Northwell Health, Sleepy Hollow, USA
| |
Collapse
|
23
|
de la Cueva A, Emmerling M, Lim SL, Yang S, Trackman PC, Sonenshein GE, Kirsch KH. A polymorphism in the lysyl oxidase propeptide domain accelerates carcinogen-induced cancer. Carcinogenesis 2018; 39:921-930. [PMID: 29579155 PMCID: PMC6692853 DOI: 10.1093/carcin/bgy045] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 02/17/2018] [Accepted: 03/20/2018] [Indexed: 01/19/2023] Open
Abstract
The propeptide (LOX-PP) domain of the lysyl oxidase proenzyme was shown to inhibit the transformed phenotype of breast, lung and pancreatic cells in culture and the formation of Her2/neu-driven breast cancer in a xenograft model. A single nucleotide polymorphism (SNP, rs1800449) positioned in a highly conserved region of LOX-PP results in an Arg158Gln substitution (humans). This arginine (Arg)→glutamine (Gln) substitution profoundly impaired the ability of LOX-PP to inhibit the invasive phenotype and xenograft tumor formation. To study the effect of the SNP in vivo, here we established a knock in (KI) mouse line (LOX-PPGln mice) expressing an Arg152Gln substitution corresponding to the human Arg158Gln polymorphism. Breast cancer was induced in wild-type (WT) and LOX-PPGln female mice beginning at 6 weeks of age by treatment with 7,12-dimethylbenz(a)anthracene (DMBA) in combination with progesterone. Time course analysis of tumor development demonstrated earlier tumor onset and shorter overall survival in LOX-PPGln versus WT mice. To further compare the tumor burden in WT and LOX-PPGln mice, inguinal mammary glands from both groups of mice were examined for microscopic lesion formation. LOX-PPGln glands contained more lesions (9.6 versus 6.9 lesions/#4 bilateral). In addition, more DMBA-treated LOX-PPGln mice had increased leukocyte infiltrations in their livers and were moribund compared with DMBA-treated WT mice. Thus, these data indicate that the Arg→Gln substitution in LOX-PP could be an important marker associated with a more aggressive cancer phenotype and that this KI model is ideal for further mechanistic studies regarding the tumor suppressor function of LOX-PP.
Collapse
Affiliation(s)
- Ana de la Cueva
- Department of Biochemistry, Boston University School of Medicine, Boston, MA, USA
| | - Michael Emmerling
- Department of Biochemistry, Boston University School of Medicine, Boston, MA, USA
| | - Sarah L Lim
- Department of Biochemistry, Boston University School of Medicine, Boston, MA, USA
| | - Shi Yang
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Philip C Trackman
- Department of Molecular and Cell Biology, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | - Gail E Sonenshein
- Department of Developmental, Molecular and Chemical Biology, Tufts University School of Medicine, Boston, MA, USA
| | - Kathrin H Kirsch
- Department of Biochemistry, Boston University School of Medicine, Boston, MA, USA
| |
Collapse
|