Breast cancer is the most common malignancy in women in the UK with well-defined algorithms of management in place in the western world. Squamous cell carcinoma of the breast is a rare entity and as such knowledge about the pathophysiology, treatment and prognosis are still uncertain. The report describes an unusual case of squamous cell carcinoma arising in an area of Zuska's disease of the breast. It illustrates the heterogeneity of the imaging findings with review of the literature. Decisions on management should be taken on an individual basis with full discussion in the multidisciplinary team meetings where all facets of the case are considered.

Metastases to the breast are well documented with cutaneous melanoma, pulmonary and gynaecological tumours accounting for the majority. It is important to consider metastatic tumour in the differential diagnosis when presented with unusual clinical or radiological findings. This study illustrates multi-system clinical findings and highlights the diversity of imaging findings in metastases to the breast. It demonstrates how metastatic melanoma treatment has been revolutionised by the introduction of targeted therapies and immunotherapy with a dramatic response to treatment with a B-raf proto-oncogene (BRAF) and Mitogen-activated protein kinase (MEK) inhibitors combination.