Reflectance Confocal Microscopy Can Help in Detecting Clinically Silent Mammary Paget’s Disease

Early detection and comprehensive diagnostic approaches for breast cancer are essential for improving prognosis. When it comes to changes in the skin of the breast or the nipple–areola complex (NAC), particularly if they are unilateral, it is essential to be vigilant, as these changes could be an ea...

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Main Authors: Carmen Cantisani, Alberto Taliano, Caterina Longo, Stefano Astorino, Vito Gomes, Gianluca Caruso, Mariano Suppa, Stefania Guida, Anna Pogorzelska-Antkowiak, Giovanni Pellacani
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Language:English
Published: MDPI AG 2024-12-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/14/23/2717
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author Carmen Cantisani
Alberto Taliano
Caterina Longo
Stefano Astorino
Vito Gomes
Gianluca Caruso
Mariano Suppa
Stefania Guida
Anna Pogorzelska-Antkowiak
Giovanni Pellacani
author_facet Carmen Cantisani
Alberto Taliano
Caterina Longo
Stefano Astorino
Vito Gomes
Gianluca Caruso
Mariano Suppa
Stefania Guida
Anna Pogorzelska-Antkowiak
Giovanni Pellacani
author_sort Carmen Cantisani
collection DOAJ
description Early detection and comprehensive diagnostic approaches for breast cancer are essential for improving prognosis. When it comes to changes in the skin of the breast or the nipple–areola complex (NAC), particularly if they are unilateral, it is essential to be vigilant, as these changes could be an early sign of underlying malignancy or other pathologies. Primary breast malignancies, such as mammary Paget’s disease (MPD), can manifest as erythema, scaling, or ulceration of the NAC, while secondary cutaneous metastases from other breast carcinomas may present as nodules, erythematous plaques, or inflammatory reactions. Non-malignant inflammatory conditions, including eczema or mastitis, can also mimic these changes; histologic evaluation is the gold-standard diagnostic tool. The usefulness of conventional diagnostic techniques breast lesions has been confirmed, but in recent years, reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) have emerged as additional tools to diagnose cases characterized by cutaneous changes; they may, therefore, result in new perspectives on the non-invasive diagnosis of MPD. RCM is a non-invasive diagnostic technique that allows high-resolution images of the skin at microscopic level in real time, offering a promising approach to the non-invasive diagnosis of MPD, particularly when a lesion is not clinically evident and may mimic other benign or inflammatory conditions. We describe an atypical clinical presentation of mammary Paget’s disease diagnosed early by reflectance confocal microscopy evaluation and confirmed histologically.
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spelling doaj-art-dc548ad6e24f4d3a8ebae9fc623e065f2025-08-20T01:55:38ZengMDPI AGDiagnostics2075-44182024-12-011423271710.3390/diagnostics14232717Reflectance Confocal Microscopy Can Help in Detecting Clinically Silent Mammary Paget’s DiseaseCarmen Cantisani0Alberto Taliano1Caterina Longo2Stefano Astorino3Vito Gomes4Gianluca Caruso5Mariano Suppa6Stefania Guida7Anna Pogorzelska-Antkowiak8Giovanni Pellacani9UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, 00161 Rome, ItalyUOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, 00161 Rome, ItalyDepartment of Dermatology, University of Modena and Reggio Emilia, 41121 Modena, ItalyUnit of Dermatology and Venereology, Celio Military Hospital, 00100 Rome, ItalyUnit of Cellular Pathology, San Filippo Neri Hospital, 00135 Rome, ItalyUnit of Cellular Pathology, San Filippo Neri Hospital, 00135 Rome, ItalyDepartment of Dermatology, Hôpital Erasme–Hôpitaux Universitaires de Bruxelles (HUB), 1000 Brussels, BelgiumSchool of Medicine, Vita-Salute San Raffaele University, 20132 Milan, ItalyEsteDerm Private Dermatology Clinic, 43-100 Tychy, PolandUOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, 00161 Rome, ItalyEarly detection and comprehensive diagnostic approaches for breast cancer are essential for improving prognosis. When it comes to changes in the skin of the breast or the nipple–areola complex (NAC), particularly if they are unilateral, it is essential to be vigilant, as these changes could be an early sign of underlying malignancy or other pathologies. Primary breast malignancies, such as mammary Paget’s disease (MPD), can manifest as erythema, scaling, or ulceration of the NAC, while secondary cutaneous metastases from other breast carcinomas may present as nodules, erythematous plaques, or inflammatory reactions. Non-malignant inflammatory conditions, including eczema or mastitis, can also mimic these changes; histologic evaluation is the gold-standard diagnostic tool. The usefulness of conventional diagnostic techniques breast lesions has been confirmed, but in recent years, reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) have emerged as additional tools to diagnose cases characterized by cutaneous changes; they may, therefore, result in new perspectives on the non-invasive diagnosis of MPD. RCM is a non-invasive diagnostic technique that allows high-resolution images of the skin at microscopic level in real time, offering a promising approach to the non-invasive diagnosis of MPD, particularly when a lesion is not clinically evident and may mimic other benign or inflammatory conditions. We describe an atypical clinical presentation of mammary Paget’s disease diagnosed early by reflectance confocal microscopy evaluation and confirmed histologically.https://www.mdpi.com/2075-4418/14/23/2717dermoscopyreflectance confocal microscopyPaget’s diseaseskin lesion
spellingShingle Carmen Cantisani
Alberto Taliano
Caterina Longo
Stefano Astorino
Vito Gomes
Gianluca Caruso
Mariano Suppa
Stefania Guida
Anna Pogorzelska-Antkowiak
Giovanni Pellacani
Reflectance Confocal Microscopy Can Help in Detecting Clinically Silent Mammary Paget’s Disease
Diagnostics
dermoscopy
reflectance confocal microscopy
Paget’s disease
skin lesion
title Reflectance Confocal Microscopy Can Help in Detecting Clinically Silent Mammary Paget’s Disease
title_full Reflectance Confocal Microscopy Can Help in Detecting Clinically Silent Mammary Paget’s Disease
title_fullStr Reflectance Confocal Microscopy Can Help in Detecting Clinically Silent Mammary Paget’s Disease
title_full_unstemmed Reflectance Confocal Microscopy Can Help in Detecting Clinically Silent Mammary Paget’s Disease
title_short Reflectance Confocal Microscopy Can Help in Detecting Clinically Silent Mammary Paget’s Disease
title_sort reflectance confocal microscopy can help in detecting clinically silent mammary paget s disease
topic dermoscopy
reflectance confocal microscopy
Paget’s disease
skin lesion
url https://www.mdpi.com/2075-4418/14/23/2717
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