Case report: Illustrating associated malignancies in Paget’s disease using contrast-enhanced mammography
IntroductionThe following presentation explores the diagnostic potential of Contrast-Enhanced Mammography (CEM) in evaluating and managing Paget’s Disease (PD) of the breast, particularly as an alternative or complementary tool to Magnetic Resonance Imaging (MRI) in cases where MRI is contraindicate...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-01-01
|
| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2024.1497506/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841555085295878144 |
|---|---|
| author | Luciano Mariano Luca Nicosia Luca Nicosia Anna Bozzini Filippo Pesapane Francesca Magnoni Giovanni Mazzarol Lorenza Meneghetti Adriana Sorce Enrico Cassano |
| author_facet | Luciano Mariano Luca Nicosia Luca Nicosia Anna Bozzini Filippo Pesapane Francesca Magnoni Giovanni Mazzarol Lorenza Meneghetti Adriana Sorce Enrico Cassano |
| author_sort | Luciano Mariano |
| collection | DOAJ |
| description | IntroductionThe following presentation explores the diagnostic potential of Contrast-Enhanced Mammography (CEM) in evaluating and managing Paget’s Disease (PD) of the breast, particularly as an alternative or complementary tool to Magnetic Resonance Imaging (MRI) in cases where MRI is contraindicated or inconclusive.Clinical casesTwo clinical cases of PD diagnosed at our Breast Imaging Division between January and May 2024 were analyzed using CEM. These cases involved imaging techniques, including Digital Mammography (DM), Breast Ultrasound (US), MRI and CEM, alongside histopathological confirmation through nipple-areolar complex (NAC) punch biopsies. CEM identified disease extensions and NAC involvement that was not evident in conventional imaging in both cases. CEM findings influenced surgical decisions, leading to total mastectomies with reconstruction instead of conservative approaches. The cases highlighted CEM’s sensitivity and ability to delineate the disease extent comparable to MRI.Discussion and conclusionsPD often presents diagnostic challenges due to frequent associations with underlying malignancies that are undetectable by standard imaging. While MRI is the gold standard, its limitations, such as costs, contraindications, and false positives, warrant alternative methods. CEM demonstrated utility in diagnosing and staging PD, offering benefits in patient acceptability, cost, and sensitivity comparable to MRI. CEM is a promising diagnostic and planning tool for PD management, especially in MRI-infeasible cases. More extensive multicentric studies will be needed to validate CEM’s role in this context. CEM could enhance PD diagnostic workflows and treatment strategies, significantly impacting clinical outcomes. |
| format | Article |
| id | doaj-art-582ea66b89e74076a0c05f71cf6d737f |
| institution | Kabale University |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-582ea66b89e74076a0c05f71cf6d737f2025-01-08T06:12:16ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-01-011410.3389/fonc.2024.14975061497506Case report: Illustrating associated malignancies in Paget’s disease using contrast-enhanced mammographyLuciano Mariano0Luca Nicosia1Luca Nicosia2Anna Bozzini3Filippo Pesapane4Francesca Magnoni5Giovanni Mazzarol6Lorenza Meneghetti7Adriana Sorce8Enrico Cassano9Breast Imaging Division, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, ItalyBreast Imaging Division, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, ItalyDepartment of Biotechnology and Life Sciences, University of Insubria, Varese, ItalyBreast Imaging Division, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, ItalyBreast Imaging Division, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, ItalyDivision of Breast Surgery, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, ItalyDivision of Pathology, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, ItalyBreast Imaging Division, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, ItalyPostgraduation School in Radiodiagnostics, Università degli Studi di Milano, Milan, ItalyBreast Imaging Division, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, ItalyIntroductionThe following presentation explores the diagnostic potential of Contrast-Enhanced Mammography (CEM) in evaluating and managing Paget’s Disease (PD) of the breast, particularly as an alternative or complementary tool to Magnetic Resonance Imaging (MRI) in cases where MRI is contraindicated or inconclusive.Clinical casesTwo clinical cases of PD diagnosed at our Breast Imaging Division between January and May 2024 were analyzed using CEM. These cases involved imaging techniques, including Digital Mammography (DM), Breast Ultrasound (US), MRI and CEM, alongside histopathological confirmation through nipple-areolar complex (NAC) punch biopsies. CEM identified disease extensions and NAC involvement that was not evident in conventional imaging in both cases. CEM findings influenced surgical decisions, leading to total mastectomies with reconstruction instead of conservative approaches. The cases highlighted CEM’s sensitivity and ability to delineate the disease extent comparable to MRI.Discussion and conclusionsPD often presents diagnostic challenges due to frequent associations with underlying malignancies that are undetectable by standard imaging. While MRI is the gold standard, its limitations, such as costs, contraindications, and false positives, warrant alternative methods. CEM demonstrated utility in diagnosing and staging PD, offering benefits in patient acceptability, cost, and sensitivity comparable to MRI. CEM is a promising diagnostic and planning tool for PD management, especially in MRI-infeasible cases. More extensive multicentric studies will be needed to validate CEM’s role in this context. CEM could enhance PD diagnostic workflows and treatment strategies, significantly impacting clinical outcomes.https://www.frontiersin.org/articles/10.3389/fonc.2024.1497506/fullcontrast enhanced mammographyCEMbreast cancerbreast imagingPaget carcinoma |
| spellingShingle | Luciano Mariano Luca Nicosia Luca Nicosia Anna Bozzini Filippo Pesapane Francesca Magnoni Giovanni Mazzarol Lorenza Meneghetti Adriana Sorce Enrico Cassano Case report: Illustrating associated malignancies in Paget’s disease using contrast-enhanced mammography Frontiers in Oncology contrast enhanced mammography CEM breast cancer breast imaging Paget carcinoma |
| title | Case report: Illustrating associated malignancies in Paget’s disease using contrast-enhanced mammography |
| title_full | Case report: Illustrating associated malignancies in Paget’s disease using contrast-enhanced mammography |
| title_fullStr | Case report: Illustrating associated malignancies in Paget’s disease using contrast-enhanced mammography |
| title_full_unstemmed | Case report: Illustrating associated malignancies in Paget’s disease using contrast-enhanced mammography |
| title_short | Case report: Illustrating associated malignancies in Paget’s disease using contrast-enhanced mammography |
| title_sort | case report illustrating associated malignancies in paget s disease using contrast enhanced mammography |
| topic | contrast enhanced mammography CEM breast cancer breast imaging Paget carcinoma |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2024.1497506/full |
| work_keys_str_mv | AT lucianomariano casereportillustratingassociatedmalignanciesinpagetsdiseaseusingcontrastenhancedmammography AT lucanicosia casereportillustratingassociatedmalignanciesinpagetsdiseaseusingcontrastenhancedmammography AT lucanicosia casereportillustratingassociatedmalignanciesinpagetsdiseaseusingcontrastenhancedmammography AT annabozzini casereportillustratingassociatedmalignanciesinpagetsdiseaseusingcontrastenhancedmammography AT filippopesapane casereportillustratingassociatedmalignanciesinpagetsdiseaseusingcontrastenhancedmammography AT francescamagnoni casereportillustratingassociatedmalignanciesinpagetsdiseaseusingcontrastenhancedmammography AT giovannimazzarol casereportillustratingassociatedmalignanciesinpagetsdiseaseusingcontrastenhancedmammography AT lorenzameneghetti casereportillustratingassociatedmalignanciesinpagetsdiseaseusingcontrastenhancedmammography AT adrianasorce casereportillustratingassociatedmalignanciesinpagetsdiseaseusingcontrastenhancedmammography AT enricocassano casereportillustratingassociatedmalignanciesinpagetsdiseaseusingcontrastenhancedmammography |