Primary squamous cell carcinoma (SCC) of the breast is a rare type of cancer, representing between 0.06% and 0.2% of malignant breast tumors. The disease presents with rapid growth and an aggressive pattern, and the lack of well-defined therapeutic protocols hinders its treatment. The following is a case report of a 64-year-old patient referred due to the appearance of a nodule in her left breast with progressive growth. On physical examination, she presented with a large breast mass (>10 cm) and palpable axillary lymph nodes. Core biopsy identified the lesion as poorly differentiated carcinoma, staged as T4d N1 Mx (inflammatory). The patient was referred for neoadjuvant chemotherapy with paclitaxel and carboplatin, but experienced tumor progression during chemotherapy and was referred for a hygienic mastectomy. The histopathological result showed an invasive carcinoma with squamous differentiation, grade 3, ulcerated with invasion of the pectoral muscle and free margins (pT4b pNx pMx). Only after immunohistochemistry was it confirmed that it was, in fact, a keratinizing squamous cell carcinoma (SCC). Postoperatively, the patient returned with signs of surgical wound dehiscence and pleuropulmonary and mediastinal metastatic progression. After multidisciplinary and family discussion, exclusive palliative care was instituted. Primary SCC of the breast presents with an aggressive clinical picture and a challenging diagnosis, requiring histopathological and immunohistochemical confirmation. The gold standard of treatment includes surgery with free margins, but there is no consensus regarding adjuvant chemotherapy. The prognosis is guarded, especially in locally advanced or metastatic cases
Primary squamous cell carcinoma (SCC) of the breast is a rare type of cancer, representing between 0.06% and 0.2% of malignant breast tumors. The disease presents with rapid growth and an aggressive pattern, and the lack of well-defined therapeutic protocols hinders its treatment. The following is a case report of a 64-year-old patient referred due to the appearance of a nodule in her left breast with progressive growth. On physical examination, she presented with a large breast mass (>10 cm) and palpable axillary lymph nodes. Core biopsy identified the lesion as poorly differentiated carcinoma, staged as T4d N1 Mx (inflammatory). The patient was referred for neoadjuvant chemotherapy with paclitaxel and carboplatin, but experienced tumor progression during chemotherapy and was referred for a hygienic mastectomy. The histopathological result showed an invasive carcinoma with squamous differentiation, grade 3, ulcerated with invasion of the pectoral muscle and free margins (pT4b pNx pMx). Only after immunohistochemistry was it confirmed that it was, in fact, a keratinizing squamous cell carcinoma (SCC). Postoperatively, the patient returned with signs of surgical wound dehiscence and pleuropulmonary and mediastinal metastatic progression. After multidisciplinary and family discussion, exclusive palliative care was instituted. Primary SCC of the breast presents with an aggressive clinical picture and a challenging diagnosis, requiring histopathological and immunohistochemical confirmation. The gold standard of treatment includes surgery with free margins, but there is no consensus regarding adjuvant chemotherapy. The prognosis is guarded, especially in locally advanced or metastatic cases