2015 Volume 64 Issue 4 Pages 257-262
A 80-year-old woman was admitted to another hospital because of a right breast tumor about 5 years ago. She received muscle preserving partial mastectomy of the right breast and axillary lymph node dissection. The pathological diagnosis revealed papillotubular carcinoma of the right breast（pT2N1M0：p-stageⅡB, HER2-R（1+），ER1+<10%, PgR-）．She had been administered anastorozole after the surgery, but CT revealed lung metastases and bilateral axillary lymph node metastases 2 years after the surgery. 7 monthes later, these metastases were getting progress in size, so the medicine was changed from anastrozole to capecitabine.
3 years and 4 monthes after the surgery, a local recurrence of the breast was found and was considered to have rapid progression, so she visited our hospital December in 2014. Though there were multiple lung metastases and multiple lymph nodes in PET/CT, we considered these metastases as non life treadning disease.
We performed a right modified radical mastectomy January in 2015. Histlogically the tumor was mixed squamous cell carcinoma and papillotubular carcinoma of the breast. There were over lying epidermis between squamous cell carcinoma and papillotubular carcinoma.
It suggested the possibility that squamous cell carcinoma occurred in de novo pattern in this case. With good clinical course, the patient discharged on 14 post operative day. S-1 was administered, but was withdrawn after 1 month due to severe nausea, so we are observing her carefully without chemotherapy.
We had better consider the squamous cell carcinoma when the patient have a local recurrent mass with rapid growth in size.
