[The Diagnostic Problem of the Automated Breast Volume Scanner(ABUS) for Paget Disease-A Case Report]

The patient, a 41-year-old woman, presented with an elastic soft tumor on her left breast. Sore skin was observed on the left nipple and areola. Mammography revealed poor extension at the left nipple surrounding skin. A hand-held ultrasonography( HHUS)device and automated breast volume scanner(ABUS)did not detect the thickening of the skin. Surgical biopsy was performed. The skin lesion was diagnosed as Paget disease. We examined her whole body and made a diagnosis of Tis N0 M0, stage 0. The patient underwent a mastectomy and sentinel lymph node biopsy. The pathological diagnosis on the basis of the resected surgical specimen was invasive ductal carcinoma, negative for ER and PgR, and positive for HER2/neu protein expression, and the Ki-67-positive cell index was 30%. The surgical margins were negative, and no metastasis was found in the sentinel lymph node. She was given trastuzumab as adjuvant therapy. Two years after the surgery, she was well without recurrence.