Paget's disease of the breast other imaging findings: Difference between revisions
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==Overview== | ==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 it as it has limited reliability in the detection of underlying [[DCIS]] in people with this [[disease]] | [[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 it as it has limited reliability in the detection of underlying [[DCIS]] in people with this [[disease]]. | ||
==Other Imaging Findings== | ==Other Imaging Findings== | ||
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*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(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>. | *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 [[Mass|masses]] or clusters of [[Micro calcifications|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 | ||
*Mammography findings include:<ref name="GaspariRicci2013">{{cite journal|last1=Gaspari|first1=Eleonora|last2=Ricci|first2=Aurora|last3=Liberto|first3=Valeria|last4=Scarano|first4=Angela Lia|last5=Fornari|first5=Maria|last6=Simonetti|first6=Giovanni|title=An Unusual Case of Mammary Paget’s Disease Diagnosed Using Dynamic Contrast-Enhanced MRI|journal=Case Reports in Radiology|volume=2013|year=2013|pages=1–5|issn=2090-6862|doi=10.1155/2013/206235}}</ref><ref name="pmid16887314">{{cite journal |vauthors=Günhan-Bilgen I, Oktay A |title=Paget's disease of the breast: clinical, mammographic, sonographic and pathologic findings in 52 cases |journal=Eur J Radiol |volume=60 |issue=2 |pages=256–63 |date=November 2006 |pmid=16887314 |doi=10.1016/j.ejrad.2006.06.010 |url=}}</ref> | *[[Mammography]] findings include:<ref name="GaspariRicci2013">{{cite journal|last1=Gaspari|first1=Eleonora|last2=Ricci|first2=Aurora|last3=Liberto|first3=Valeria|last4=Scarano|first4=Angela Lia|last5=Fornari|first5=Maria|last6=Simonetti|first6=Giovanni|title=An Unusual Case of Mammary Paget’s Disease Diagnosed Using Dynamic Contrast-Enhanced MRI|journal=Case Reports in Radiology|volume=2013|year=2013|pages=1–5|issn=2090-6862|doi=10.1155/2013/206235}}</ref><ref name="pmid16887314">{{cite journal |vauthors=Günhan-Bilgen I, Oktay A |title=Paget's disease of the breast: clinical, mammographic, sonographic and pathologic findings in 52 cases |journal=Eur J Radiol |volume=60 |issue=2 |pages=256–63 |date=November 2006 |pmid=16887314 |doi=10.1016/j.ejrad.2006.06.010 |url=}}</ref> | ||
*[[Skin]] thickening | *[[Skin]] thickening | ||
*[[Malignant]] [[calcification]] | *[[Malignant]] [[calcification]] | ||
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*Architectural distortion | *Architectural distortion | ||
*[[Nipple]] retraction | *[[Nipple]] retraction | ||
*However, literature reports that [[ | *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=== | ===99mTc MIBI prone scinti-mammography=== | ||
*Intraductal proliferative Paget cells are shown to have a strong and characteristic 99mTc MIBI uptake. | *[[Intraductal]] proliferative Paget cells are shown to have a strong and characteristic [[99mTc MIBI]] uptake. | ||
*This is said to be due to the proliferation, | *This is said to be due to the proliferation, [[tumor]] 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> | *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> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Preeti Singh, 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 it as it has limited reliability in the detection of underlying DCIS in people with this disease.
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, tumor 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.