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Japanese Journal of Clinical Oncology 30:279-282 (2000)
© 2000 Foundation for Promotion of Cancer Research

Primary Squamous Cell Carcinoma of the Breast During Lactation: a Case Report

Nana Rokutanda1, Yuichi Iino2, Takao Yokoe2, Michio Maemura1, Jun Horiguchi1, Hiroyuki Takei1, Yukio Koibuchi1, Kotaro Iijima1, Tetsunari Oyama3 and Yasuo Morishita1,+

1Second Department of Surgery, 2Department of Emergency and Critical Care Medicine and 3Second Department of Pathology, Gunma University School of Medicine, Maebashi, Gunma, Japan

A case of primary squamous cell carcinoma of the breast during lactation is reported. The patient was a 32-year-old woman, in post-partum lactating 18 months after delivery, who was referred to our hospital following detection of a lump in her left breast during physical examination in mass screening for breast cancer. The tumor, palpated in the upper outer quadrant of the left breast, was firm, well-defined and 2.8 x 2.6 cm in size. Ultrasonograms identified an irregular-shaped hypoechoic lesion and mammograms revealed a well-defined, circumscribed tumor. Based on these findings, breast cancer was suspected and an excisional biopsy was performed. The resected specimen was a firm, solid and circumscribed tumor with central hemorrhage. Microscopic findings demonstrated that the tumor consisted of an invasive ductal carcinoma with marked squamous metaplasia, such as keratinization and squamo-columnar junction. Breast-conserving surgery was performed and no lymph node involvement was noted. Both estrogen and progesterone receptors of the tumor were negative. Generally, the size of both squamous cell carcinoma and carcinoma during the lactation period tends to be larger than ordinary carcinomas. In this case, the cancerous lesion was detected at a relatively early stage. Although the cancerous lesion was detected at a relatively early stage and no lymph node involvement was noted, lung metastases occurred within 12 months of the surgery. Malignant potential is generally considered to be high in cases of squamous cell carcinoma of the breast with lactation and thus intensive treatment potentially resulting in severe side effects was considered to be necessary for this patient.

+ For reprints and all correspondence: Nana Rokutanda, Second Department of Surgery, Gunma University School of Medicine, 3–39–15 Showa-machi, Maebashi, Gunma 371-8511, Japan


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