Clinical Imaging Characteristics and Pathological Subtypes of 19 Cases of Paget's Disease of the Breast

Objective ​ ​ To analyze the clinical and imaging features of mammary Paget's disease (MPD) and enhance diagnostic recognition to reduce misdiagnosis rates. Methods ​ ​ A retrospective analysis was performed on 19 pathologically confirmed MPD cases at The First Affiliated Hospital of Bengbu Medical University (January 2018–March 2025). Clinical presentations, imaging characteristics, and pathological findings were evaluated. Results ​ ​ Seventeen patients (89.5%) presented with initial symptoms of eczematoid changes in the nipple-areolar complex. Concurrent ductal carcinoma in situ (DCIS) or invasive ductal carcinoma (IDC) was identified in 16 cases (84.2%). Mammographic calcifications were detected in 16 cases (84.2%). Among DCIS cases, 7 showed nodular high-density masses and 10 demonstrated calcifications. All IDC cases presented heterogeneous calcifications. Surgical intervention was universally performed. Conclusion ​ ​ MPD demonstrates high rates of calcification (84.2%), concurrent malignancy (84.2%), and initial eczematoid nipple changes (89.5%). For clinically suspected MPD cases, further diagnostic investigations ​are warranted. Definitive diagnosis requires pathological verification to improve early diagnostic accuracy and reduce misdiagnosis.