case_images: PMC9881019_01
case_images: Left mammography in oblique mediolateral (a) and craniocaudal (b) views, featuring a high-density nodule, irregularly shaped and indistinct and spiculated margins, best assessed in tomosynthesis (c) and (d), located at the upper-outer quadrant, corresponding to the palpable complaint - BI-RADS  4C. Ultrasonography (e) shows a nodule of solid, hypoechoic, irregular and angled nature.
case_images: bd-41-bd220027-g001.jpg
case_images: PMC9881019_01_bd-41-bd220027-g001.jpg
case_images: bd-41-bd220027-g001
case_images: On ultrasonography, a solid, hypoechoic and irregular nodule was observed (Fig. 1), suggesting a primary breast lesion.
case_images: Histology - (a) invasive carcinoma with squamous differentiation and keratinization in breast segmentectomy material (Histological section, hematoxylin and eosin, 100x); (b) strong and diffuse immunopositivity for the p16 marker (p16, DAKO, 200 x); (c and d) detection of signals by the in-situ hybridization technique (ISH) for high risk HPV (Ventana Infomr HPV III Family 16 probe for HPV genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58 and 66) - 200 and 400x increase, respectively.
case_images: bd-41-bd220027-g002.jpg
case_images: PMC9881019_01_bd-41-bd220027-g002.jpg
case_images: bd-41-bd220027-g002
case_images: The immunohistochemical evaluation showed positivity for p16 and in situ hybridization for high-risk HPV 16 was positive (B) (Fig. 2).