Ultrasound computed tomography (USCT) is a promising technique for breast imaging. It provides three modalities: echo image, sound speed image (SSI), and attenuation image. The echo image reveals structural details of the breast with high resolution but is not quantitative. The SSI is quantitative, but its resolution is generally lower than that of the echo image. The SSI reconstruction is an ill-posed problem, thus the Tikhonov or total variation (TV) regularization methods are generally used. Tikhonov regularization is stable, but it tends to smooth the SSI and results in low resolution. TV regularization can preserve the sharp edges and provide higher resolution, but it may result in staircase artifacts. To combine the advantages of Tikhonov and TV regularizations, this article proposes a combined regularization method using prior structural information from the echo image. The proposed method mainly includes three steps. First, the echo image is reconstructed using the synthetic aperture (SA) technique and then segmented into breast and water regions. The segmentation result is used as prior structural information. Second, the USCT sound propagation forward model was built. Finally, with a penalty term according to the prior structural information, the combined regularization method is used to reconstruct the SSI. Both simulation and ex vivo experiments were conducted for evaluation. In the simulation, the proposed method has a low root-mean-square-error (13.78 m/s), a high correlation coefficient (0.812), a high structural similarity (0.755), and a low standard deviation of water sound speed (2.33 m/s). In the ex vivo experiment, the method has a low standard deviation of water sound speed (1.44 and 3.13 m/s for small and large objects, respectively), a low contrast to noise ratio (3.09 and 5.08), and a high Dice coefficient (0.92 and 0.97). Thus, the proposed combined regularization method using prior structural information can improve reconstruction quality.