AboutClaes-Gustaf Nordquist, M.D. Expertise I`m a doctor of medicine and a specialist in radiation therapy and medical oncology. I have long experience in diagnostics and treatment of breast tumours.
Experience I'm a Doctor of Medicine. Licensed/certified physician and surgeon and specialist in Medical Oncology and Radiation therapy in Sweden, Denmark, Finland, Iceland, Norway and the European Union. Background in Radiation Therapy, Medical Oncology, Radiation Protection, Nuclear Medicine, Diagnostic Radiology, Gynecological Oncology, Clinical Pathology, Clinical Cytology,Hematology and Internal Medicine. M.D. from the faculty of medicine, Royal Karolinska Institute, Stockholm, Sweden. Have also been an exchange student at the Hebrew University, Hadassah Medical School, Jerusalem Israel. Former medical consultant, Swedish National Board of Radiation Protection. Former Police Surgeon and Medical Examiner, Stockholm Police Department. Former Chief Medical Officer, The Royal Guards, The Royal Horse Guards and the Royal Household Brigade, Royal Swedish Army Medical Corps. Now in private practice in Stockholm, Sweden.
Question I had a fibroid mass for years in my right breast. This spring I noticed it was larger and more dense. In July I found lumps in my right armpit. Mamms/Diagnostic ultrasound showed a fluid filled complex mass. FN aspiration drained 5cc of only white blood cells (no bacteria). Core biopsy path report said Squamous Cell Carcinoma. CT scan ruled out other source tumors. Second opinion path report said it's a primary SCC of the breast (.04-.07% rare). Second FNA of mass yielded another 3cc cystic fluid. FNA of lymph nodes was positive for SCC. Surgeon recommends partial masectomy and axillary clearance. Could this be a mis-diagnosed complex mass with partial cyst? Oncology Journals online state certain cysts appear identical to SCC under the microscope. State university doctors say it is SCC, but all based on path reports. There is no treatment protocol. Only 4 cases seen in 14 years at UM. Help! Should I have the surgery or request further surgical biopsy?
Answer We SHOULD believe pathology reports! It is the strongest foundation we have for our actions! I strongly recommend that you follow the surgery recommendation and that surgery is followed by both radiation therapy (axilla, sternal region, supraclavicular region and remaining breast) and chemotherapy since your cancer had spread to lymph nodes. Even though there is no protocol for this we can still rely on common cancer experience! Good luck! Yes it is indeed rare! I can not remember a single case.
Well, yes I have never seen one, but I have a lot of (general) cancer experience so a 1 in knowledge is just insulting. You state yourself that your state university hospital has only seen 4 cases in 14 years. So it is not improbable or inconceivable for a single cancer doctor to go through life without seeing a single case of this kind of rare tumor! The notion that this is a misdiagnosed cyst is ridiculous. A cyst does not produce any lymph node metastases as are present in your case and CT scans (PET scans too?) did rule out any other tumor. So your diagnosis is probably correct (since you gave me just a 4 in politeness I feel free not to mince words here). Anyway I STRONGLY suggest that you follow the advice of your doctors and the advice I gave above. With lymph node metastases present your cancer is at least a stage 3 cancer so its treatment will not be a picnic. Your case is a serious one and should be treated as one!
