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Usefulness of MRI in detecting occult breast cancer associated with Paget's disease of the nipple–areolar complex

Section of Breast Imaging of the ¹ Department of Radiology, ² OSATEK MRI, ³ Department of Pathology and ⁴ Department of Gynaecology, Galdakao Hospital, Barrio Labeaga s/n 48960 Galdakao, Vizcaya, Spain

MRI allows for the detection of mammographically and clinically occult breast neoplasms. We analysed the ability of MRI to detect occult breast cancer in three patients with Paget's disease of the nipple–areolar complex, proven histologically. In all three cases we observed differences in the morphological and dynamic features of healthy and pathological nipples, and we also found enhancement foci in breast tissue, with suspicious kinetic and morphological characteristics, which in the case of two patients corresponded to ductal carcinoma in situ. The detection and location with MRI of underlying neoplastic foci may be of help in choosing the most reasonable and conservative treatment in these patients.