Paget's disease of the breast biopsy: Difference between revisions
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{{CMG}};{{AE}} {{PSK}} | {{CMG}};{{AE}} {{PSK}} | ||
==Overview== | ==Overview== | ||
A full-thickness biopsy of the [[nipple]] and areola is important for establishing the diagnosis of Paget's disease of the [[breast]]. Findings on [[biopsy]] diagnostic of Paget's disease of the breast include presence of Paget cells, which are arranged in solid groups. | A full-thickness biopsy of the [[nipple]] and areola is important for establishing the diagnosis of Paget's disease of the [[breast]]. Findings on [[biopsy]] diagnostic of Paget's disease of the breast include presence of Paget cells, which are arranged in solid groups. | ||
==Biopsy== | ==Biopsy== | ||
*The diagnosis of Paget's disease can be made from a wedge biopsy, a superficial shave biopsy of epidermis or from a punch biopsy. | *The diagnosis of Paget's disease can be made from a [[Biopsy|wedge biopsy]], a superficial shave [[biopsy]] of [[epidermis]] or from a punch [[biopsy]]. | ||
*Wedge biopsy is the most useful method to make the diagnosis because the biopsy is likely to include the epidermis and a part of lactiferous duct. | *Wedge [[biopsy]] is the most useful method to make the diagnosis because the [[biopsy]] is likely to include the [[epidermis]] and a part of [[lactiferous duct]]. | ||
*It is essential that the sample contains part of the [[lactiferous duct]] and if the areola is affected, it also needs to be represented in the sample to confirm the diagnosis. | *It is essential that the sample contains part of the [[lactiferous duct]] and if the [[areola]] is affected, it also needs to be represented in the [[sample]] to confirm the [[diagnosis]]. | ||
*A shave biopsy is less likely to contain sufficient number of Paget's cells, especially when the surface of the lesion is ulcerated. | *A shave [[biopsy]] is less likely to contain sufficient number of Paget's cells, especially when the surface of the [[lesion]] is [[Ulcer|ulcerated]]. | ||
*A punch biopsy will include the underlying stroma and possibly part of a duct. It frequently | *A punch [[biopsy]] will include the underlying [[stroma]] and possibly part of a [[duct]]. It frequently provides less [[epidermis]] to examine. | ||
*Many times a full-thickness biopsy of the [[nipple]] and areola is important for establishing the diagnosis of Paget's disease of the [[breast]]. | *Many times a full-thickness [[biopsy]] of the [[nipple]] and [[areola]] is important for establishing the diagnosis of Paget's disease of the [[breast]]. | ||
* This is especially in a patient with | * This is especially in a patient with [[nipple]]–[[areola]] [[skin]] changes.<ref name="Lopes FilhoLopes2015">{{cite journal|last1=Lopes Filho|first1=Lauro Lourival|last2=Lopes|first2=Ione Maria Ribeiro Soares|last3=Lopes|first3=Lauro Rodolpho Soares|last4=Enokihara|first4=Milvia M. S. S.|last5=Michalany|first5=Alexandre Osores|last6=Matsunaga|first6=Nobuo|title=Mammary and extramammary Paget's disease|journal=Anais Brasileiros de Dermatologia|volume=90|issue=2|year=2015|pages=225–231|issn=1806-4841|doi=10.1590/abd1806-4841.20153189}}</ref> <ref>{{cite book | last = Rosen | first = Paul | title = Rosen's breast pathology | publisher = Wolters Kluwer Health/Lippincott Williams & Wilkins | location = Philadelphia | year = 2014 | isbn = 9781451176537 }}</ref> | ||
*Biopsy is not always successful, therefore, it is at times necessary to take a second biopsy or to excise the nipple. | *[[Biopsy]] is not always successful, therefore, it is at times necessary to take a second [[biopsy]] or to excise the [[nipple]]. | ||
*Often histological exams are inconclusive and more biopsies, or even surgical removal of the entire [[nipple]] may be required. | *Often [[histological]] exams are inconclusive and more [[Biopsy|biopsies]], or even surgical removal of the entire [[nipple]] may be required. | ||
*The main histological characteristic is the presence of Paget cells, which are arranged in solid groups. | *The main [[histological]] characteristic is the presence of Paget cells, which are arranged in solid groups. | ||
*On occasion, they form glandular arrangements outlining the basal [[epidermis]] and exhibit migration to the granular layer, similarly to [[melanocytes]]. | *On occasion, they form [[Glandular tissue|glandular]] arrangements outlining the basal [[epidermis]] and exhibit migration to the [[granular layer]], similarly to [[melanocytes]]. | ||
To view histopathologic characteristic features of Paget's disease of the breast, click [[Paget's disease of the breast pathophysiology|'''here''']]. | To view [[histopathologic]] characteristic features of Paget's disease of the breast, click [[Paget's disease of the breast pathophysiology|'''here''']]. | ||
==References== | ==References== | ||
Revision as of 17:45, 14 March 2019
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Paget's disease of the breast Microchapters |
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Differentiating Paget's disease of the breast from other Diseases |
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Diagnosis |
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Paget's disease of the breast biopsy On the Web |
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American Roentgen Ray Society Images of Paget's disease of the breast biopsy |
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Directions to Hospitals Treating Paget's disease of the breast |
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Risk calculators and risk factors for Paget's disease of the breast biopsy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Suveenkrishna Pothuru, M.B,B.S. [2]
Overview
A full-thickness biopsy of the nipple and areola is important for establishing the diagnosis of Paget's disease of the breast. Findings on biopsy diagnostic of Paget's disease of the breast include presence of Paget cells, which are arranged in solid groups.
Biopsy
- The diagnosis of Paget's disease can be made from a wedge biopsy, a superficial shave biopsy of epidermis or from a punch biopsy.
- Wedge biopsy is the most useful method to make the diagnosis because the biopsy is likely to include the epidermis and a part of lactiferous duct.
- It is essential that the sample contains part of the lactiferous duct and if the areola is affected, it also needs to be represented in the sample to confirm the diagnosis.
- A shave biopsy is less likely to contain sufficient number of Paget's cells, especially when the surface of the lesion is ulcerated.
- A punch biopsy will include the underlying stroma and possibly part of a duct. It frequently provides less epidermis to examine.
- Many times a full-thickness biopsy of the nipple and areola is important for establishing the diagnosis of Paget's disease of the breast.
- This is especially in a patient with nipple–areola skin changes.[1] [2]
- Biopsy is not always successful, therefore, it is at times necessary to take a second biopsy or to excise the nipple.
- Often histological exams are inconclusive and more biopsies, or even surgical removal of the entire nipple may be required.
- The main histological characteristic is the presence of Paget cells, which are arranged in solid groups.
- On occasion, they form glandular arrangements outlining the basal epidermis and exhibit migration to the granular layer, similarly to melanocytes.
To view histopathologic characteristic features of Paget's disease of the breast, click here.
References
- ↑ Lopes Filho, Lauro Lourival; Lopes, Ione Maria Ribeiro Soares; Lopes, Lauro Rodolpho Soares; Enokihara, Milvia M. S. S.; Michalany, Alexandre Osores; Matsunaga, Nobuo (2015). "Mammary and extramammary Paget's disease". Anais Brasileiros de Dermatologia. 90 (2): 225–231. doi:10.1590/abd1806-4841.20153189. ISSN 1806-4841.
- ↑ Rosen, Paul (2014). Rosen's breast pathology. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 9781451176537.