Background <p>Breast implants are widely used in plastic surgery and generally considered safe. However, recent reports of implant-associated malignancies, including anaplastic large-cell lymphoma and squamous-cell carcinoma, have raised concern. This report presents a case of squamous-cell carcinoma arising in a silicone breast implant and reviews the current literature on its association with breast implants.</p> Case presentation <p>A 48-year-old Hispanic female presented with pain and asymmetry of the left breast. Persistent symptoms and imaging findings led to the identification of a cystic mass associated with a silicone implant. Histopathological analysis confirmed squamous-cell carcinoma arising from the periprosthetic capsule. The patient underwent implant removal, and after radiologic surveillance and diagnosis of recurrence, an attempted oncoplastic approach was converted intraoperatively to a radical mastectomy due to extensive tumor infiltration. No adjuvant therapy was administered. At 12-month follow-up, the patient remains disease-free without evidence of recurrence.</p> Conclusions <p>The diagnosis and management of breast-implant-associated squamous-cell carcinoma require a multidisciplinary approach due to its unpredictable behavior. Increased awareness, early detection, and individualized treatment strategies are essential to improve outcomes in this rare but aggressive entity.</p>