Paget's disease of the breast areola mimicking cutaneous melanoma

Sonya Mitchell, Roberto Lachica, M. Barry Randall, Derrick J. Beech

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Paget's disease of the breast nipple and areola complex represents a cutaneous manifestation of an underlying breast malignancy. The typical skin changes characteristic of breast Paget's disease are usually easily distinguished from those found of malignant melanoma. The rare finding of a pigmented cutaneous breast lesion mimicking melanoma presents a diagnostic dilemma. This case presentation describes a pigmented mammary lesion involving the areola that had undergone changes in diameter and pigmentation. The lesion was not associated with nipple drainage, nipple excoriation, dermal ulceration, or a palpable breast mass. The areola lesion was highly suggestive of a dermatologic malignancy such as malignant melanoma. As such, a biopsy was performed with initial findings suggestive of cutaneous melanoma. Upon more detailed analysis of a larger excision specimen, immunohistochemical staining was highly supportive of the diagnosis of breast Paget's disease. A total mastectomy with sentinel lymph node evaluation was performed along with immediate reconstruction. The final pathology revealed a small focus of ductal carcinoma in situ of the breast associated with the areola changes. Histologic and immunohistochemical analysis of a biopsy specimen were paramount in differentiating these two lesions.

Original languageEnglish (US)
Pages (from-to)233-236
Number of pages4
JournalBreast Journal
Volume12
Issue number3
DOIs
StatePublished - May 1 2006

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Mammary Paget's Disease
Nipples
Melanoma
Breast
Skin
Simple Mastectomy
Biopsy
Skin Manifestations
Carcinoma, Intraductal, Noninfiltrating
Pigmentation
Drainage
Neoplasms
Pathology
Staining and Labeling

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Surgery
  • Oncology

Cite this

Paget's disease of the breast areola mimicking cutaneous melanoma. / Mitchell, Sonya; Lachica, Roberto; Randall, M. Barry; Beech, Derrick J.

In: Breast Journal, Vol. 12, No. 3, 01.05.2006, p. 233-236.

Research output: Contribution to journalArticle

Mitchell, Sonya ; Lachica, Roberto ; Randall, M. Barry ; Beech, Derrick J. / Paget's disease of the breast areola mimicking cutaneous melanoma. In: Breast Journal. 2006 ; Vol. 12, No. 3. pp. 233-236.
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