Paget's disease of the nipple is associated with an underlying breast carcinoma in what proportion of cases, and what is the diagnostic investigation of choice for confirming nipple involvement?
- A 10–20%; punch biopsy of nipple skin
- B >95%; scrape/wedge biopsy or punch biopsy of nipple skin ✓
- C 50–60%; nipple discharge cytology
- D 70%; ductogram of major ducts
Correct answer: B. >95%; scrape/wedge biopsy or punch biopsy of nipple skin
Explanation
Paget's disease of the nipple is associated with underlying in situ or invasive ductal carcinoma in over 95% of cases. The diagnosis is confirmed by demonstrating Paget cells (large, pale, vacuolated cells with prominent nuclei) on punch or wedge biopsy of the nipple-areola complex. Nipple discharge cytology is less sensitive. A ductogram evaluates ductal patency but does not diagnose Paget's cells directly.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.