Paget disease of the breast

Case contributed by Dr Garth Kruger

Presentation

A 75 year old lady has left nipple retraction and a scaly skin irritation on the nipple itself. Sent for diagnostic mammography

Patient Data

Age: 75
Gender: Female
Mammography
Ultrasound
Photo

Case Discussion

The single mammographic view shows nipple retraction and focal skin thickening around the nipple. A vage density is present just under the nipple. The ultrasound shows a solid irregular lesion under the areola; all the hallmarks of malognancy are there. There are even single microcalcifications. The histology was an Infiltrating ductal carcinoma on the ultrasound guided core biopsies. Node negative in this case.

The scaly skin irritation is the key to the diagnosis. Be aware that it could indicate a sinsiter abnormailty in the breast deep to the nipple. Look at the technologist work sheet for this observation

The Paget who described this disease in 1875 is the same Paget of bone disease fame.

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Case information

rID: 18503
Case created: 10th Jul 2012
Last edited: 9th Dec 2015
System: Breast
Inclusion in quiz mode: Included

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