ArticleCureus2025
Subnipple Cyst Formation Is an Important Diagnostic Clue for Mixed-Type Squamous Cell Carcinomas of the Breast: A Case Report.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
It is well known that breast squamous cell carcinomas (SCCs) have highly cystic components. It, however, is not yet known whether the location of cystic areas contributes to the diagnosis of breast SCCs. A 62-year-old woman with a right breast mass was referred to our hospital. Mammography showed an oval mass just under the right nipple and distortion of the adjacent mammary gland with pleomorphic calcifications. Ultrasound showed a subnipple large oval cystic lesion with solid parts, microcalcifications, and an adjacent polygonal mass, both with a high depth/width ratio and internal punctuate high echoes. Magnetic resonance imaging (MRI) of the masses clarified the connection between the two masses at their deep borders and showed low signals on T1-weighted images and high and slightly high signals at the cyst and mass parts on T2-weighted images, respectively. Core needle biopsy of the solid mass pathologically showed atypical cells growing in tubular and cord-like fashions with connective tissue proliferation, leading to the diagnosis of scirrhous type invasive ductal carcinoma (IDC). The patient, therefore, underwent mastectomy and sentinel node biopsy, showing pathological node negativity on frozen section. Postoperative pathological study showed that the scirrhous type IDC cells were connected to pleomorphic spindle cells and further tied up to SCC cells with central cystic structures. In addition to estrogen and progesterone receptor negativity, immunostaining showed human epidermal growth factor receptor type 2 (HER2) negativity in the IDC components and equivocality in the SCC components. Thereafter, fluorescence in situ hybridization clarified no amplification of human epidermal growth factor receptor type 2 (HER2) genes in the SCC components. The patient recovered uneventfully, received dose-dense chemotherapy, and is scheduled for long-term follow-up on an outpatient basis. Diagnostic physicians should consider mixed-type breast SCCs when breast tumors have cystic structures just under the nipple and an adjacent solid mass.
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