Paget's disease of the breast other imaging findings: Difference between revisions
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===Mammogram=== | ===Mammogram=== | ||
In clinical suspicion of Paget's disease of the breast, [[mammography]] can help to detect the underlying malignancy, but is not always a reliable procedure for detecting Paget's disease of the breast. | *In clinical suspicion of Paget's disease of the breast, [[mammography]] can help to detect the underlying malignancy, but is not always a reliable procedure for detecting Paget's disease of the breast. | ||
*It has limited reliability in the detection of underlying [[DCIS]] in women with Paget's disease.<ref name="pmid8396786">{{cite journal |vauthors=Ikeda DM, Helvie MA, Frank TS, Chapel KL, Andersson IT |title=Paget disease of the nipple: radiologic-pathologic correlation |journal=Radiology |volume=189 |issue=1 |pages=89–94 |date=October 1993 |pmid=8396786 |doi=10.1148/radiology.189.1.8396786 |url=}}</ref> | *It has limited reliability in the detection of underlying [[DCIS]] in women with Paget's disease.<ref name="pmid8396786">{{cite journal |vauthors=Ikeda DM, Helvie MA, Frank TS, Chapel KL, Andersson IT |title=Paget disease of the nipple: radiologic-pathologic correlation |journal=Radiology |volume=189 |issue=1 |pages=89–94 |date=October 1993 |pmid=8396786 |doi=10.1148/radiology.189.1.8396786 |url=}}</ref> | ||
*The sensitivity of mammography is said to be significantly higher in the presence of a palpable mass<ref name="pmid8143409">{{cite journal |vauthors=Sawyer RH, Asbury DL |title=Mammographic appearances in Paget's disease of the breast |journal=Clin Radiol |volume=49 |issue=3 |pages=185–8 |date=March 1994 |pmid=8143409 |doi= |url=}}</ref>. | *The sensitivity of mammography is said to be significantly higher in the presence of a palpable mass(97%), as opposed to disease confined to the nipple in the absence of a palpable mass (50%)<ref name="pmid8143409">{{cite journal |vauthors=Sawyer RH, Asbury DL |title=Mammographic appearances in Paget's disease of the breast |journal=Clin Radiol |volume=49 |issue=3 |pages=185–8 |date=March 1994 |pmid=8143409 |doi= |url=}}</ref><ref name="pmid8396786">{{cite journal |vauthors=Ikeda DM, Helvie MA, Frank TS, Chapel KL, Andersson IT |title=Paget disease of the nipple: radiologic-pathologic correlation |journal=Radiology |volume=189 |issue=1 |pages=89–94 |date=October 1993 |pmid=8396786 |doi=10.1148/radiology.189.1.8396786 |url=}}</ref>. | ||
*Mammography is done bilaterally to asses the contralateral breast, for masses or clusters of microcalcifications, to exclude multifocal disease. | *Mammography is done bilaterally to asses the contralateral breast, for masses or clusters of microcalcifications, to exclude multifocal disease. | ||
*Mammography should be used for follow-up visits in patients | *Mammography should be used for follow-up visits in patients | ||
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*Architectural distortion | *Architectural distortion | ||
*Nipple retraction | *Nipple retraction | ||
*However, literature reports that [[mammographic|mammography]] finding can be negative in 22%–50% of patients. As underlying carcinoma is common even in women with a [[benign]] [[mammogram]] and no palpable mass, the breast [[ultrasound]] and MRI may be useful in detecting the lesion. [[Ultrasound]] can be considered a part of initial evaluation and helpful for increasing [[sensitivity]] of [[mammography]]. | |||
===99mTc MIBI prone scinti-mammography=== | |||
*Intraductal proliferative Paget cells are shown to have a strong and characteristic 99mTc MIBI uptake. | |||
*This is said to be due to the proliferation, tumour growth and the oncogene overexpression of Paget’s cells. | |||
*Literature correlating Paget's disease of he breast with this technique is limited.<ref name="ScopinaroMezi1998">{{cite journal|last1=Scopinaro|first1=F|last2=Mezi|first2=S|last3=Ierardi|first3=M|last4=De Vincentis|first4=G|last5=Tiberio|first5=N S|last6=David|first6=V|last7=Maggi|first7=S|last8=Sallusti|first8=E|last9=Modesti|first9=M|title=99mTc MIBI prone scintimammography in patients with suspicious breast cancer: relationship with mammography and tumor size.|journal=International Journal of Oncology|year=1998|issn=1019-6439|doi=10.3892/ijo.12.3.661}}</ref> | |||
==References== | ==References== | ||
Revision as of 15:29, 8 March 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Suveenkrishna Pothuru, M.B,B.S. [2]
Overview
Mammogram may be performed to detect the breast cancer associated with Paget's disease of the breast, but is not always a reliable procedure for detecting Paget's disease of the breast.
Other Imaging Findings
Mammogram
- In clinical suspicion of Paget's disease of the breast, mammography can help to detect the underlying malignancy, but is not always a reliable procedure for detecting Paget's disease of the breast.
- It has limited reliability in the detection of underlying DCIS in women with Paget's disease.[1]
- The sensitivity of mammography is said to be significantly higher in the presence of a palpable mass(97%), as opposed to disease confined to the nipple in the absence of a palpable mass (50%)[2][1].
- Mammography is done bilaterally to asses the contralateral breast, for masses or clusters of microcalcifications, to exclude multifocal disease.
- Mammography should be used for follow-up visits in patients
- Mammography findings include:[3][4]
- Skin thickening
- Malignant calcification
- Masses at the level of the nipple
- Architectural distortion
- Nipple retraction
- However, literature reports that mammography finding can be negative in 22%–50% of patients. As underlying carcinoma is common even in women with a benign mammogram and no palpable mass, the breast ultrasound and MRI may be useful in detecting the lesion. Ultrasound can be considered a part of initial evaluation and helpful for increasing sensitivity of mammography.
99mTc MIBI prone scinti-mammography
- Intraductal proliferative Paget cells are shown to have a strong and characteristic 99mTc MIBI uptake.
- This is said to be due to the proliferation, tumour growth and the oncogene overexpression of Paget’s cells.
- Literature correlating Paget's disease of he breast with this technique is limited.[5]
References
- ↑ 1.0 1.1 Ikeda DM, Helvie MA, Frank TS, Chapel KL, Andersson IT (October 1993). "Paget disease of the nipple: radiologic-pathologic correlation". Radiology. 189 (1): 89–94. doi:10.1148/radiology.189.1.8396786. PMID 8396786.
- ↑ Sawyer RH, Asbury DL (March 1994). "Mammographic appearances in Paget's disease of the breast". Clin Radiol. 49 (3): 185–8. PMID 8143409.
- ↑ Gaspari, Eleonora; Ricci, Aurora; Liberto, Valeria; Scarano, Angela Lia; Fornari, Maria; Simonetti, Giovanni (2013). "An Unusual Case of Mammary Paget's Disease Diagnosed Using Dynamic Contrast-Enhanced MRI". Case Reports in Radiology. 2013: 1–5. doi:10.1155/2013/206235. ISSN 2090-6862.
- ↑ Günhan-Bilgen I, Oktay A (November 2006). "Paget's disease of the breast: clinical, mammographic, sonographic and pathologic findings in 52 cases". Eur J Radiol. 60 (2): 256–63. doi:10.1016/j.ejrad.2006.06.010. PMID 16887314.
- ↑ Scopinaro, F; Mezi, S; Ierardi, M; De Vincentis, G; Tiberio, N S; David, V; Maggi, S; Sallusti, E; Modesti, M (1998). "99mTc MIBI prone scintimammography in patients with suspicious breast cancer: relationship with mammography and tumor size". International Journal of Oncology. doi:10.3892/ijo.12.3.661. ISSN 1019-6439.