Authored by Nguyen Le Thao Tram, MSc, MD, – Diagnostic Imaging Doctor – Department of Diagnostic Imaging, Vinmec Nha Trang International Hospital
Paget’s disease of the breast is a skin condition often found in older women. Its first signs include skin changes on the breast and around the nipple. This article provides detailed information about Paget’s disease images.
1. What is Paget's Disease of the Breast?
Paget’s disease of the breast, or nipple Paget’s disease, is a malignant condition caused by cancer cells infiltrating the epidermis of the nipple. Most cases involve carcinoma in situ (CIS), either localized or invasive. However, in some instances, Paget’s disease is confined to the skin of the nipple-areola area without underlying tumors.
Paget’s disease accounts for 1–5% of malignant breast diseases, with an average age of onset between 53–59 years. The disease is characterized by inflammation and eczema-like changes in the nipple and areola, such as skin darkening. It is categorized into four stages. In the first stage (stage 0), initial symptoms include itching, flaking, and abnormal nipple discharge, limited to the epidermis without DCIS underneath. For later stages, cancerous lesions can be localized under the nipple (stage 1), spread (stage 2) and progress to invasive ductal carcinoma (stage 3).
In most patients with Paget’s disease, typical malignant or Paget cells are found in the outermost layer of the nipple’s skin under microscopic examination. These cells may spread to the terminal ducts. The exact cause of Paget’s disease is still unknown.
2. Images of Paget's disease of the breast using diagnostic imaging techniques
2.1. Mammogram
Mammograms detect Paget’s disease with approximately 50% sensitivity. Diagnostic features may include skin thickening, nipple retraction, malignant microcalcifications, or diffuse/clustered calcifications under or around the nipple-areola area.
2.2. Breast MRI
Breast MRI is the preferred method for evaluating and diagnosing Paget’s disease of the breast when clinical or mammogram findings are insufficient to confirm breast cancer. On MRI images, Paget’s disease may show abnormal enhancement of the nipple or clustered, linear enhancement patterns. These findings are often associated with ductal carcinoma in situ (DCIS) and Paget’s disease. Additionally, breast MRI is an optimal tool for assessing lesions during and after treatment.
Breast cancer is a common cancer in women, causing many deaths worldwide each year. Early detection significantly improves treatment outcomes, with a high chance of cure and no recurrence. Therefore, breast cancer screening is essential, especially for high-risk individuals.
Currently, Vinmec International Hospital offers a Breast Cancer Screening Package for women of various age groups. At Vinmec, there is a full range of necessary medical equipment and modern machinery to support breast cancer examination, diagnosis, testing, imaging, and treatment across various stages. This includes mammography and advanced 3.0 Tesla MRI machines with Silent technology. MRI is one of the safest and most accurate imaging methods available today, providing non-invasive diagnostics without the use of X-rays. MRI is one of the safest and most accurate imaging methods available today, offering non-invasive diagnostics without using X-rays.
At Vinmec, breast examination and diagnosis follow a standardized process conducted by highly trained and certified medical professionals. The team ensures quick and effective management. With Vinmec’s early detection and screening package, customers can identify breast cancer even before symptoms appear.
Please dial HOTLINE for more information or register for an appointment HERE. Download MyVinmec app to make appointments faster and to manage your bookings easily.
References:
https://radiopaedia.org/articles/paget-disease-breast?lang=us
