OBJECTIVE: To review the mammographic and ultrasonographic features of
primary breast cancer containing squamous cell carcinoma. PATIENTS AN
D METHODS: From medical records for breast cancer patients seen over a
37-year period the authors identified 19 patients with squamous cell
carcinoma, for 5 of whom histologic sections and imaging studies were
available. The tumours were classified on the basis of histologic find
ings as pure (in two patients) or predominantly (in three patients) sq
uamous cell carcinoma. Mammograms were available for four of the patie
nts, and the mammographic report only was available for analysis for t
he fifth. Ultrasonography had been performed for four of the patients;
the images were available for two of the patients and the reports onl
y for two. RESULTS: The median age of the patients was 55 years, The m
ean size of the tumours, all of which were palpable, was 5.0 cm. None
of the tumours was connected to the skin, arose in the nipple-areolar
complex or was metastatic. On mammography, the margins of all five mas
ses, which were oval in shape, were indistinct and partly well-circums
cribed; in three cases, the tumour margin was also partly spiculated.
No malignant microcalcifications were seen. The two ''pure'' squamous
cell carcinoma tumours appeared on ultrasonography as solid hypoechoic
masses, and two of the predominantly squamous cell carcinoma tumours
had both cystic and solid components. At gross pathological examinatio
n, four of the tumours (two ''pure'' and two predominantly squamous ce
ll carcinoma) were cystic, which reflected areas of necrosis and cyst
formation. CONCLUSION: Although ''pure'' or predominantly squamous cel
l carcinoma is: a rare histologic variant of breast cancer that lacks
any typical mammographic features, this tumour can be added to the dif
ferential diagnosis of cystic breast masses seen on ultrasoqography.