Unusual case of Paget disease of the nipple diagnosed by nipple scraping cytology.

Paget disease of the nipple is a rare presentation of breast cancer. It is sometimes mistaken for a benign skin condition of the nipple and surrounding areola, which can significantly delay the diagnosis and treatment. In over 90% of cases there is an underlying carcinoma, either ductal carcinoma in situ (DCIS) or invasive breast cancer. We present a rare case of Paget disease of the nipple without the typical characteristics, detected by simple nipple scraping technique. A 62-year-old woman presented with a small fissure on the left nipple with scant clear nipple discharge. There were no other changes to the nipple-areola complex. The mammography and ultrasound were unremarkable. However, nipple scraping provided the immediate cytological diagnosis of Paget disease. Breast MRI with core biopsy showed high grade ductal carcinoma in situ with suggestion of microinvasion, confirmed histologically after mastectomy. Nipple scraping is a simple and inexpensive technique, which can be used in the office without anesthesia and with minimal discomfort to the patient. It could allow for significantly earlier cancer detection and treatment at the earliest stage of breast cancer. However, if the results are negative, full thickness biopsy may be needed if clinically indicated.

Corrigendum: Unusual case of Paget disease of the nipple diagnosed by nipple scraping cytology.

The original article was published on March 15, 2020 and corrected on April 15, 2020. The revised version of the article adds an Acknowledgements section. The changes appear in the revised online PDF copy of this article.

Case of necrotizing infection of the breast and brief review of literature.

Necrotizing infections are rapidly spreading progressive infections with necrosis of the subcutaneous tissue that can have severe complications. We report a case of right breast necrotizing mastitis in a 40-year-old postpartum woman who presented in septic shock. The patient was resuscitated with intravenous fluids and broad-spectrum antibiotics, followed by urgent surgical debridement. We discuss the patient's presentation, our treatment approach, and outcomes, with a brief review of the literature. We conclude that necrotizing breast infections are rare, but must be known to obstetricians and breast and surgical oncologists, because without urgent treatment and surgical debridement, the mortality risk is high.