Pigmented mammary Paget disease (PMPD) is a rare subtype of mammary Paget disease that presents as a hyperpigmented patch or plaque over the areola and nipple. We herein report on an unusual case of PMPD with reticulated features in a 98-year-old female. The histology showed intraepidermal pagetoid cells containing melanin pigments without any underlying intraductal carcinoma.
Carcinoma, Intraductal, Noninfiltrating ; Female ; Humans ; Melanins ; Nipples ; Paget's Disease, Mammary

Erosive adenomatosis of the nipple is a rare, benign neoplasm, currently thought to originate from the terminal lactiferous ducts and subareolar breast tissue. Clinically, erosive adenomatosis of the nipple is often indistinguishable from that of mammary Paget's disease, and it could be misdiagnosed as intraductal carcinoma as it has a similar histological finding. We present the case of a 36-year-old woman who had a unilateral erythematous induration of the nipple that contained a palpable, firm nodule. It had first been noticed 2 years earlier. The surface was occasionally crusted, and there was a bloody discharge. Histopathological examination showed irregular, dilated tubular structures, which were lined by a peripheral layer of cuboidal cells and a luminal layer of the columnar cells that demonstrated decapitation secretion at their luminal border.
Adult ; Breast ; Breast Neoplasms ; Carcinoma, Intraductal, Noninfiltrating ; Decapitation ; Female ; Humans ; Nipples ; Paget's Disease, Mammary ; Papilloma ; Phenobarbital

No abstract available.
Breast* ; Carcinoma, Intraductal, Noninfiltrating* ; Fibroadenoma*

No abstract available.
Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating*

Pigmented mammary Paget's disease is a rare variant of mammary Paget's disease, and this mimics malignant melanoma both clinically and histopathologically. Two women aged 48 and 44 years old, respectively, presented with 2-cm pigmented patches and 1-cm pigmented erosive crusted papules without discharge or palpable masses, respectively. They had previously undergone breast-conserving surgery following the diagnosis of intraductal carcinoma of the breast. Physical examinations and imaging studies revealed no evidence of the recurrence of breast cancer. However, histopathological and immunohistochemical analyses demonstrated the presence of 1) Paget's cells in the epidermis and these cells contained melanin within their cytoplasm and 2) numerous melanophages in the upper dermis. We diagnosed the two patients with pigmented Paget's disease. Subsequent pathological analyses revealed recurrent intraductal carcinoma. We recommend that skin biopsies should be taken from patients presenting with pigmented lesions of the nipple, who have previously undergone breast-conserving treatment, to test the possibility of cancer recurrence.
Aged ; Biopsy ; Breast ; Breast Neoplasms ; Carcinoma, Intraductal, Noninfiltrating ; Cytoplasm ; Dermis ; Epidermis ; Female ; Humans ; Mastectomy, Segmental ; Melanins ; Melanoma ; Nipples ; Paget's Disease, Mammary ; Physical Examination ; Recurrence ; Skin

PURPOSE: Paget's disease of the breast (PDB) occurs in approximately 1~3% of all primary breast carcinomas. This study aimed to determine the optimal surgical treatments for PDB in this study. METHODS: The medical records of 16 patients with PDB who had been treated between January 1986 and December 1998 were clinically reviewed retrospectively. Results: 13 patients had nipple changes consistent with clinical Paget' disease (CPD) including 8 who had an associated breast mass, and 5 who had no associated mass. Of the 13 patients with CPD, 12 were treated with a modified radical mastectomy while 1 was treated with a radical mastectomy. Breast cancer (BC) was found in all of 13 patients (100%) with CPD. The BC was centrally located in 46% of patients including 38% in CPD associated with the mass and 60% in CPD not associated with the mass. Out of 8 CPD patients associated with the mass, 7 (88%) had invasive cancer, 1 (12%) had a ductal carcinoma in situ (DCIS), and 2 (25%) had pathologic axillary nodes (PAN). The 5 year survival rate was 87.5%. Of the 5 CPD patients not associated with the mass, 4 (80%) had an invasive cancer, 1 (20%) had a DCIS and none had PAN. Their 5 year survival rate is 100%. CONCLUSION:All the patients with CPD had an associated BC. BC is more frequently centrally located in the CPD not associated with the mass (60%) than those associated with the mass (38%). Contrarily, the BC in CPD that was not associated with the mass was located more peripherally (40%). Therefore, the treatment of patients with CPD must be individualized in order to avoid under or overtreatment.
Breast ; Breast Neoplasms ; Carcinoma, Intraductal, Noninfiltrating ; Humans ; Mastectomy, Modified Radical ; Mastectomy, Radical ; Medical Records ; Nipples ; Paget's Disease, Mammary* ; Retrospective Studies ; Survival Rate

PURPOSE: Paget's disease of the breast (PDB) occurs in approximately 1~3% of all primary breast carcinomas. This study aimed to determine the optimal surgical treatments for PDB in this study. METHODS: The medical records of 16 patients with PDB who had been treated between January 1986 and December 1998 were clinically reviewed retrospectively. RESULTS: 13 patients had nipple changes consistent with clinical Paget' disease (CPD) including 8 who had an associated breast mass, and 5 who had no associated mass. Of the 13 patients with CPD, 12 were treated with a modified radical mastectomy while 1 was treated with a radical mastectomy. Breast cancer (BC) was found in all of 13 patients (100%) with CPD. The BC was centrally located in 46% of patients including 38% in CPD associated with the mass and 60% in CPD not associated with the mass. Out of 8 CPD patients associated with the mass, 7 (88%) had invasive cancer, 1 (12%) had a ductal carcinoma in situ (DCIS), and 2 (25%) had pathologic axillary nodes (PAN). The 5 year survival rate was 87.5%. Of the 5 CPD patients not associated with the mass, 4 (80%) had an invasive cancer, 1 (20%) had a DCIS and none had PAN. Their 5 year survival rate is 100%. CONCLUSION: All the patients with CPD had an associated BC. BC is more frequently centrally located in the CPD not associated with the mass (60%) than those associated with the mass (38%). Contrarily, the BC in CPD that was not associated with the mass was located more peripherally (40%). Therefore, the treatment of patients with CPD must be individualized in order to avoid under or overtreatment.
Breast ; Breast Neoplasms ; Carcinoma, Intraductal, Noninfiltrating ; Humans ; Mastectomy, Modified Radical ; Mastectomy, Radical ; Medical Records ; Nipples ; Paget's Disease, Mammary* ; Retrospective Studies ; Survival Rate

PURPOSE: Architectural distortion is a suspicious abnormality for the diagnosis of breast cancer. The aim of this study was to investigate the clinical significance of sonographically detected architectural distortion. MATERIALS AND METHODS: From January 2006 to June 2008, 20 patients were identified who had sonographically detected architectural distortions without a history of trauma or surgery and abnormal mammographic findings related to an architectural distortion. All of the lesions were pathologically verified. We evaluated the clinical and pathological findings and then assessed the clinical significance of the sonographically detected architectural distortions. RESULTS: Based on the clinical findings, one (5%) of the 20 patients had a palpable lump and the remaining 19 patients had no symptoms. No patient had a family history of breast cancer. Based on the pathological findings, three (15%) patients had malignancies. The malignant lesions included invasive ductal carcinomas (n = 2) and ductal carcinoma in situ (n = 1). Four (20%) patients had high-risk lesions; atypical ductal hyperplasia (n = 3) and lobular carcinoma in situ (n = 1). The remaining 13 (65%) patients had benign lesions, however, seven (35%) out of 13 patients had mild-risk lesions (three intraductal papillomas, three moderate or florid epithelial hyperplasia and one sclerosing adenosis). CONCLUSION: Of the sonographically detected architectural distortions, 35% were breast cancers or high-risk lesions and 35% were mild-risk lesions. Thus, a biopsy might be needed for an architectural distortion without an associated mass as depicted on breast ultrasound, even though the mammographic findings are normal.
Biopsy ; Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Carcinoma, Lobular ; Humans ; Hyperplasia ; Mammography ; Papilloma, Intraductal

PURPOSE: To compare the mammographic features and histologic subtypes of ductal carcinoma in situ(DCIS) of the breast. MATERIALS AND METHODS: Mammograms of 34 patients with DCIS of the breast detected between January 1992 and November 1998 were retrospectively analyzed. Histologic subtypes were classified as either comedo or noncomedo. Mammographic findings were classified in one of four ways : microcalcification only, microcalcification with mass, mass or asymmetrical density only, or normal. Microcalcifications was classified as either predominantly casting or granular. We also determined whether microcalcification was multifocal. RESULTS: Histologic examination revealed the comedo type in eight patients and the noncomedo type in 26. Among the eight comedo-type cases, mammography demonstrated microcalcification only in five and micro-calcification with mass in three. Among 26 noncomedo-type cases, microcalcifications only was seen in ten, microcalcification with mass in two, mass or asymmetrical density only in six, and normal features in eight. Six of the comedo type were predominantly casting and two were predominantly granular. Predominantly casting calcification was present in four of 12 cases of the noncomedo type and predominatly granular was in eight. Multifocality was seen in four comedo-type cases, but in none of those that were of the noncomedo type. CONCLUSION: We conclude that the comedo subtype of DCIS of the breast is more likely than the noncomedo subtype to be accompanied by microcalcification of the predominantly casting type. Multifocally located microcalcification is a more frequent feature of the comedo subtype than of the noncomedo subtype.
Breast ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Humans ; Mammography ; Retrospective Studies

PURPOSE: To verify the role of additional sonography on routine mammograms in the diagnosis of ductal carcinoma in situ (DCIS). MATERIALS AND METHODS: Between 2005 and 2008, a total of 105 breasts belonging to 102 patients were diagnosed with DCIS by surgery. Preoperative ultrasound and mammographic findings and reports using BI-RADS were retrospectively reviewed and analyzed. In both mammogram and ultrasound, BI-RADS categories 1, 2, and 3 were regarded as negative results and categories 4 and 5 as positive results. We analyzed the frequency in which additional ultrasound examinations aided in the diagnosis in each mammographic finding. RESULTS: Out of the 105 cases, 96 showed positive results on a mammogram and 9 cases showed negative results. Clustered microcalcifications, positive mammographic findings, were found most often (64/96, 66.67%). In those cases, ultrasound examinations gave no additional information, but did enablesonographically-guided biopsies in 38. In the 32 cases with other positive mammographic findings, ultrasound examinations were helpful in 15 cases. Of the 9 cases showing negative results on a mammogram, 8 cases were correctly diagnosed with DCIS because of the additionally-performed ultrasound examination, but 1 case returned a false negative on both the mammogram and ultrasound examination. CONCLUSION: Additional sonography contributes to a diagnosis of DCIS in patients with negative mammographic findings, nonspecific mammographic findings, or multifocal lesions.
Biopsy ; Breast ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Humans ; Retrospective Studies