关键词: Dermatose Dermatosis Eczema Eczéma Maladie de Paget du mamelon Nipple-areola complex Paget's disease of the nipple Plaque aréolomamelonnaire

Mesh : Breast Diseases / diagnosis diagnostic imaging Eczema / diagnosis drug therapy Female Humans Nipples / pathology Practice Guidelines as Topic Radiography

来  源:   DOI:10.1016/j.jgyn.2015.09.040   PDF(Sci-hub)

Abstract:
A change in the shape or appearance of the nipple-areola complex, especially if it is unilateral and recent appearance, is a sign of underlying breast tumor. Breast imaging is then required (grade C). Any erythematous lesion of the nipple or nipple-areola can be a Paget\'s disease, an adenoma of the nipple or a nipple eczema. Clinical course and pattern can point to a diagnosis without sufficient specificity (LE4). If nipple eczema is suspected, it is recommended to perform a test treatment with topical corticosteroids. In case of failure or if a Paget\'s disease of the breast is suspected, a biopsy must be done. When indicated, it is not possible to recommend a biopsy modality (scrape cytology, punch biopsy, nipple core biopsy and surgical excision) compared to another. When imaging exploration of the nipple-areola complex is necessary, ultrasound and mammography are recommended as first-line. In the absence of signal, an MRI is recommended as second-line (grade C).
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