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: 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, 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.