Primary squamous cell carcinoma of the breast
A 72-year-old postmenopausal lady presented with a lump in the right breast. The lump was gradually progressive in size, not associated with pain, nipple discharge and retraction or dimpling of the skin. There was no family history of breast malignancy. Physical examination revealed firm, rubbery, non-tender and non-mobile lesion of 8 × 7 cm in upper outer quadrant of the right breast. Axillary lymph nodes were not enlarged. Mammogram of the right breast demonstrated a spherical mass lesion with ill-defined speculated margins. The skin and the nipple-areola complex were not involved. Lumpectomy was performed. Grossly, the tumor was 8 × 6 × 4 cm in size. The cut section showed gray white appearance with few cystic areas. On histopathology, diagnosis of SqCC with involvement of surgical margins was given. An extensive work-up ruled out other primary site or metastatic disease. Right modified radical mastectomy with axillary lymph nodes dissection was performed. Microscopically, the tumor was composed of sheets and clusters of round to polyhedral cells with pleomorphic hyperchromatic nuclei and a moderate amount of eosinophilic cytoplasm. Individual cell keratinization and keratin pearls were also seen []. The tumor cells were positive for cytokeratin and negative for estrogen and progesterone receptors. Hence diagnosis of primary SqCC of the breast was given. All 12 axillary lymph nodes were free of tumor. Overlying skin and areola was uninvolved by tumor.