PAGET-DISEASE OF THE BREAST - A PICTORIAL ESSAY

Paget disease of the breast accounts for approximately 2%-3% of breast cancers. It is characterized by infiltration of the nipple epidermis by adenocarcinoma cells, which cause an eczematous eruption on the nip ple and areola. The clinical features are highly suggestive of the dis ease; awareness of these an the part of the clinician should lead to m ore prompt diagnosis and earlier initiation of appropriate treatment. Mammograms, although not always positive, should be obtained in all ca ses suggestive of Paget disease to search for the underlying tumor and direct further treatment. Findings that may be seen at mammography in clude skin thickening, nipple retraction, subareolar or more diffuse m alignant microcalcifications, and a discrete mass or masses. However, a negative mammogram should not alter the course of treatment. Convers ely, identification of subareolar mammographic findings should alert t he clinician to search for physical signs in the nipple and areolar re gion suggestive of Paget disease.