Abstract
PURPOSE: Contrast-enhanced magnetic resonance imaging (CE-MRI) is an essential imaging modality for planning breast cancer surgical procedures. However, CE-MRI findings in Paget's disease of the breast (PD) have not been studied extensively. This study aimed to elucidate the CE-MRI findings of PD and assess their role in surgical treatment planning. METHODS: Twelve patients with PD who underwent surgery between 2011 and 2023 were retrospectively analyzed. RESULTS: The average patient age was 73.8 ± 14.3 years. CE-MRI detected enhanced areas in the nipple-areola complex (NAC) and/or surrounding skin in all patients. Additionally, 6 patients showed enhanced areas within the breast, suggesting ductal spread into the breast. Of these, 1 patient underwent breast-conserving surgery (BCS), and 5 opted for mastectomy. Pathology confirmed the extent of ductal spread of PD, as indicated by CE-MRI. Among the 6 patients who did not have an enhanced area in the breast, 3 underwent BCS or central lumpectomy including NAC, and 3 chose mastectomy based on the patient's preference, and no malignant foci were observed in the breast. CONCLUSION: CE-MRI effectively evaluated the ductal spread of PD in the breast, demonstrating its utility in guiding the selection of surgical procedures.