Mammographic appearances in Paget's disease of the breast

The mammographic appearances in 17 patients with Paget's disease of the breast were retrospectively reviewed. Appearances were normal in only five cases. Microcalcification was present in 10 including one where it encircled the nipple. A radiologically-visible tumour was seen in nine breasts with carcinoma being diagnosed in a further three by the pattern of calcification alone. Multifocal tumours were present in four breasts but no lymphadenopathy or contralateral tumours were seen. Despite high quality radiography a tumour was only detected in 71% of cases of Paget's disease and radiographers should be trained to recognize the condition clinically. Patients without a visible tumour may be suitable for radiotherapy.