Paget's disease of the breast other imaging findings

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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[2].
  • 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, the literature reports that the mammography 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.

References

  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.
  2. Sawyer RH, Asbury DL (March 1994). "Mammographic appearances in Paget's disease of the breast". Clin Radiol. 49 (3): 185–8. PMID 8143409.
  3. 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.
  4. 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.

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