Background/Objectives: Squamous cell metaplastic breast carcinoma (SCMBC) is a rare and aggressive breast cancer subtype with limited imaging and prognostic data. This study aimed to characterize the multimodal imaging features, clinicopathological profiles, and prognostic outcomes of SCMBC in a single-center cohort. Methods: We retrospectively analyzed 22 patients with histopathologically confirmed SCMBC treated between January 2012 and May 2025. Clinicopathological profiles, multimodal imaging features, and prognostic outcomes were collected and evaluated. Results: All patients were female (median age 64.5 years; range, 34–82). The majority (59.1%) presented with clinical stage II disease. Axillary lymph node metastasis was present in eight (36.4%) patients at diagnosis, with one case of distant lung metastasis. The mean tumor diameter was 4.24 cm (range, 2.1–11.8). MRI findings (n = 13) included heterogeneous internal structure, a low mean apparent diffusion coefficient (ADC) value of 0.98 × 10−3 mm2/s, and frequent necrosis (92.3%). Pathologically, 54.5% of tumors were high-grade, and 81.8% exhibited a triple-negative phenotype. After a median follow-up of 34 months, the 5-year overall survival (OS) rate was 64.3%, while the 3-year disease-free survival (DFS) rate was 42.1%. The recurrence/metastasis rate was 22.7% (5/22), and all five deaths occurred in this subgroup. Conclusions: SCMBC is characterized by suggestive multimodal imaging features, a predominant triple-negative phenotype, and a high risk of early recurrence. Given the exploratory nature of this single-center study with a limited sample size, these findings require validation in larger, prospective cohorts. Early radiological identification and aggressive personalized treatment strategies may improve outcomes for patients with this aggressive disease.
Pan et al. (Tue,) studied this question.