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A new technique for the histological diagnosis of Paget's disease of the breast using a semiautomated core needle biopsy with a 14-gauge needle

  • Breast Radiology
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

The aim of our work is to illustrate a new technique for the histological diagnosis of Paget’s disease (PD) using a core needle biopsy with a semiautomated 14-gauge needle called nipple-core needle biopsy (N-CNB). We report 3 years’ experience in our senology unit.

Materials and methods

Twenty-six women with 26 clinical of nipple–areola complex (NAC) changes with suspected PD and subjected to core needle biopsy using our new 14G semiautomated needle technique were included in our study group. Institutional review board approval was obtained for this retrospective analysis. A semiautomated biopsy gun with a 14-gauge, 15-cm-long needle was used for this new procedure. After a subcutaneous injection of anesthetic and spray-ice application to the NAC, the 14G needle was opened with the cradle exposed and positioned on the NAC with considerable pressure exerted on the same. The cradle was then closed by triggering the needle spring, and 2–4 core samples were withdrawn by moving the needle position each time. Clinical, instrumental and histological differences between the lesions that gave benign results after N-CNB and those that resulted PD were analyzed by applying the Fisher's exact test.

Results

After N-CNB, 13/26 lesions were found to be PD (50%) while 13/26 alterations were benign (50%). No malignant lesions were detected during the follow-up in patients with benign N-CNB results. The diagnosis of PD obtained with N-CNB was confirmed in all 13 cases by means of a histological analysis of the surgical specimens. No significant post-biopsy complications were recorded. Patients with PD more frequently presented nipple retraction (ρ = 0.0407) and associated suspicious (i.e., BI-RADS 4 and 5) mammographic (ρ = 0.0006) findings compared to patients whose N-CNB had given benign results and the difference was statistically significant.

Conclusions

In conclusion, with this novel technique, we were able to obtain an easy, painless, major complication-free and accurate diagnosis of PD of the NAC using a semiautomated core needle biopsy with a 14-gauge needle.

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Funding

No funds, grants, or other support was received.

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Authors and Affiliations

  1. Diagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Largo G. A. Brambilla 3, 50134, Florence, Italy

    Jacopo Nori, Giulia Bicchierai, Diego De Benedetto, Cecilia Boeri, Ermanno Vanzi & Federica Di Naro

  2. Radiology Department, Ospedale San Giovanni Di Dio, Agrigento, Italy

    Francesco Amato

  3. Division of Pathological Anatomy, University of Florence, Florence, Italy

    Simonetta Bianchi

  4. Emergency Radiology Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

    Vittorio Miele

Authors
  1. Jacopo Nori
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  2. Giulia Bicchierai
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  3. Francesco Amato
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  4. Diego De Benedetto
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  5. Cecilia Boeri
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  6. Ermanno Vanzi
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  7. Federica Di Naro
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  8. Simonetta Bianchi
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  9. Vittorio Miele
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by GB, SB and FA. The first draft of the manuscript was written by GB and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Giulia Bicchierai.

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Conflicts of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Human Investigation Committee (IRB) of AOU Careggi approved this study.

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Informed consent was obtained from all individual participants included in the study.

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The authors affirm that human research participants provided informed consent for publication of the images in Figs. 1, 2, 3 and 4.

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Nori, J., Bicchierai, G., Amato, F. et al. A new technique for the histological diagnosis of Paget's disease of the breast using a semiautomated core needle biopsy with a 14-gauge needle. Radiol med 126, 936–945 (2021). https://doi.org/10.1007/s11547-021-01358-4

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  • DOI: https://doi.org/10.1007/s11547-021-01358-4

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