# Primary squamous cell carcinoma of the breast: a case report

## TL;DR

A rare case of squamous cell carcinoma of the breast with spindle cell features was diagnosed and successfully treated, with the patient remaining disease-free for over four years.

## Contribution

This case report highlights the diagnostic challenges and management of a rare spindle cell variant of breast cancer.

## Key findings

- The tumor exhibited sarcomatoid growth pattern and spindle-shaped cells with severe atypicality.
- Immunohistochemical staining showed positivity for P63, P53, vimentin, and CKpan, but negativity for estrogen receptor and C-erbB-2.
- The patient remained disease-free for over four years following surgery, chemotherapy, and radiotherapy.

## Abstract

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.

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.

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.