Paget Disease of the Breast - Diagnosis

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How is Paget disease of the breast diagnosed?

A nipple biopsy allows doctors to correctly diagnose Paget disease of the breast. There are several types of nipple biopsy, including the procedures described below.

  • Surface biopsy: A glass slide or other tool is used to gently scrape cells from the surface of the skin.
  • Shave biopsy: A razor-like tool is used to remove the top layer of skin.
  • Punch biopsy: A circular cutting tool, called a punch, is used to remove a disk-shaped piece of tissue.
  • Wedge biopsy: A scalpel is used to remove a small wedge of tissue.

In some cases, doctors may remove the entire nipple. A pathologist then examines the cells or tissue under a microscope to look for Paget cells.

Most people who have Paget disease of the breast also have one or more tumors inside the same breast. In addition to ordering a nipple biopsy, the doctor should perform a clinical breast exam to check for lumps or other breast changes. As many as 50 percent of people who have Paget disease of the breast have a breast lump that can be felt in a clinical breast exam. The doctor may order additional diagnostic tests, such as a diagnostic mammogram, an ultrasound exam, or a magnetic resonance imaging scan to look for possible tumors.

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