Fine Needle Aspiration Cytodiagnosis of Primary and Metastatic Squamous Cell Carcinoma of the Breast

Gupta, Raj K.

doi:10.1159/000332686

Cited by 11 publications

(8 citation statements)

References 6 publications

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“…Occasional case reports describing cytologic features of squamous cell/adenosquamous carcinoma of the breast are on record. [8][9][10][11][12][13][14][15][16][17][18][19] Mammary squamous cell carcinoma and adenosquamous carcinoma are sometimes misdiagnosed as high grade invasive ductal carcinoma, NOS, on cytologic or even histologic assessment. This is especially true as most of these metaplastic tumors are poorly differentiated.…”

Section: Discussionmentioning

confidence: 99%

Significance of Squamous Cells in Fine Needle Aspiration Cytology of the Breast

Ng¹,

Kong²

2003

Acta Cytologica

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Section: Discussionmentioning

confidence: 99%

Significance of Squamous Cells in Fine Needle Aspiration Cytology of the Breast

Ng¹,

Kong²

2003

Acta Cytologica

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“…1). Cohesive and squamous cells are described which are hyperchromatic, containing dense nuclei; angulated thickened nuclear membranes; and coarse chromatin 21 22 and FNAB is the initial diagnostic tool of choice.…”

Section: Discussionmentioning

confidence: 99%

Primary squamous cell carcinoma of the breast

Moisidis¹,

Ahmed²,

Carmalt³

et al. 2002

ANZ Journal of Surgery

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Primary squamous cell carcinoma (SCC) of the breast is a rare condition that has been reported in the literature for over 70 years. We present a series of five cases and discuss management of this condition. METHODSFive (5) primary squamous cell cancers of the breast were identified from the Strathfield Breast Centre database which has prospectively recorded 1658 breast cancers for the period 1989-1999. These records were reviewed, the criteria for inclusion as primary squamous cell cancers were verified and the histopathology was reviewed. CASE REPORTS Case 1A 69-year-old woman presented with a large fungating mass, filling the lateral half of her right breast and a large clinically involved right axillary lymph node. She also presented with mid-thoracic back pain. Computed tomography (CT) scans confirmed the large soft tissue mass in the right axilla but also revealed a right-sided pleural effusion and extensive vertebral body destruction. Bone scans confirmed widespread metastatic carcinoma, and a core biopsy of the breast confirmed squamous cell carcinoma. The patient died of her distant metastatic disease while receiving palliative radiotherapy. Case 2A 71-year-old woman presented with a large cystic mass in her left breast. Aspiration of the cyst resulted in resolution of the mass, and cytological evaluation revealed occasional large degenerate atypical and vacuolated cells of uncertain significance together with macrophages and inflammatory cells. The mass recurred twice over the ensuing 2 months and was subsequently excised. Histopathology showed a cystic mass containing a poorly differentiated squamous carcinoma. The patient proceeded to the completion of mastectomy and in-continuity axillary dissection. Of the 25 axillary nodes examined, none contained metastatic disease. The patient remains alive and disease-free four years postoperatively. Case 3A 50-year-old woman presented with a fungating right breast mass. The mass was fixed to the chest wall but investigations revealed no evidence of metastatic disease. Fine needle cytology and subsequent core biopsy revealed squamous cell carcinoma. She was treated initially with chemotherapy (5-fluorouracil and cisplatinum) followed by radiotherapy. She did not complete therapy due to poor compliance, and when she presented several months later she was noted to have a mass measuring 8 cm in diameter, fixed to the chest wall and clinically involving axillary nodes. Investigations again failed to demonstrate any evidence of spread outside the axilla and after extensive discussions a Halsted radical mastectomy was carried out together with excision of part of the chest wall, removing the third to sixth ribs. A Goretex graft repair of the chest wall and a latissimus dorsi rotation flap with split skin graft were required for reconstruction. Local excision of the tumour was deemed histologically clear from both the chest wall and axilla with only one of the 16 lymph nodes examined containing metastatic SCC. Despite this treatment though, the chest wall tumour recurr...

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“…34 The presence of malignant cells with glandular features in addition to the malignant squamous cells would favor the cytologic diagnosis of a ductal carcinoma with squamous differentiation. 34 In breast cancer surgery, seroma formation occurs more frequently in patients undergoing breast-conserving procedures with axillary node dissections than in patients undergoing modified radical mastectomy with immediate reconstruction. 35 In one study, seroma formation occurred in 40% of the patients with no closed-suction drainage compared to 6% of patients with closed-suction drainage.…”

Section: Discussionmentioning

confidence: 99%

Atypical squamous metaplasia of seromas in breast needle aspirates from irradiated lumpectomy sites: A potential pitfall for false‐positive diagnoses of carcinoma

Silverman

Julian

Clary

et al. 2002

Diagnostic Cytopathology

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The presence of squamous metaplasic cells is an uncommon finding in fine-needle aspiration (FNA) biopsies of the breast. We report that FNA smears containing atypical squamous metaplastic cells derived from the lining of seroma-type cavities following lumpectomy and irradiation in patients with breast cancer can be a potential pitfall for a false-positive diagnosis of recurrent malignancy. Four fine-needle breast aspirates from two adult patients with previous histories of invasive breast carcinoma were retrieved. One specimen was from a 56-yr-old female, while the remaining three FNAs aspirates were from a 75-yr-old female. Both patients presented with indurated cystic lesions arising at irradiated lumpectomy sites. The cytospins from the 56-yr-old patient showed markedly atypical cells having enlarged, degenerating, hyperchromatic nuclei and surrounding dense cytoplasm with sharp borders that were suspicious for carcinoma. A mastectomy revealed irradiation changes and atypical squamous metaplastic cells lining a cystic cavity consistent with a seroma, but there was no evidence of residual cancer. After three aspirations yielded "atypical" diagnoses, the second patient underwent core needle biopsies that also revealed changes consistent with a seroma cavity lined by atypical squamous metaplastic cells. We believe this is the first report of squamous metaplasia occurring in a seroma cavity following lumpectomy and irradiation of the breast. The squamous metaplastic cells in aspirates of these cystic lesions may display significant cellular atypia that can potentially result in a false-positive diagnosis of malignancy.

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Fine Needle Aspiration Cytodiagnosis of Primary and Metastatic Squamous Cell Carcinoma of the Breast

Cited by 11 publications

References 6 publications

Significance of Squamous Cells in Fine Needle Aspiration Cytology of the Breast

Significance of Squamous Cells in Fine Needle Aspiration Cytology of the Breast

Primary squamous cell carcinoma of the breast

Atypical squamous metaplasia of seromas in breast needle aspirates from irradiated lumpectomy sites: A potential pitfall for false‐positive diagnoses of carcinoma

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