Background

Extramammary Paget disease (EMPD) sometimes shows an ill-defined border and an unexpectedly extended tumor spread beyond the clinical borders. Mapping biopsy is 1 approach for complete surgical removal, but its efficacy has remained controversial.

Objective

We sought to evaluate mapping biopsies for EMPD.

Methods

We performed a retrospective review of 133 patients with 150 primary EMPD lesions. We histopathologically examined 1182 skin biopsy specimens (975 from mapping biopsy and 207 from lesional biopsy).

Results

Only 1.6% of mapping biopsy specimens from well-defined EMPD (13 of 810) were positive. Moreover, 4.6% of mapping biopsy specimens from ill-defined EMPD (8 of 165) were positive, whereas all specimens taken from sites 2 cm or more from the clinical border were negative. For both well-defined and ill-defined EMPD, there was no significant difference in the margin status of surgical resection regardless of mapping biopsy.

Limitations

This was a retrospective study.

Conclusions

Mapping biopsies are unnecessary for well-defined EMPD or when 2-cm margins can be achieved, whereas surgical removal with predetermined margins (1 cm for well-defined EMPD and 2 cm for ill-defined EMPD) appears to be safe. Mapping biopsies can be considered when shortening of the safe surgical margin to less than 2 cm is required in ill-defined EMPD.

中文翻译：

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乳房外Paget病的定位活检标本的评估：一项回顾性研究

背景

乳腺Paget病（EMPD）有时显示边界不清，并且肿瘤扩散超出临床范围。活检图是完全手术切除的一种方法，但其疗效仍存在争议。

客观的

我们试图评估针对EMPD的活检标本。

方法

我们对133例150例原发性EMPD病变的患者进行了回顾性研究。我们进行了组织病理学检查，检查了1182例皮肤活检标本（其中975例来自作图活检，207例来自病灶活检）。

结果

来自明确定义的EMPD的地图活检标本中只有1.6％（810个中的13个）为阳性。此外，来自不确定的EMPD的4.6％活检标本为阳性（165个中的8个）为阳性，而从距临床边界2 cm或更远处采集的所有标本均为阴性。对于定义明确和定义不明确的EMPD，无论作何活检标本，手术切除的边缘状态均无显着差异。

局限性

这是一项回顾性研究。

结论

对于明确定义的EMPD或可以达到2 cm的切缘，无需进行活检标本，而具有预定切缘的手术切除（明确定义的EMPD为1 cm，不明确定义的EMPD为2 cm）似乎是安全的。在不确定的EMPD中需要将安全手术切缘缩短至2 cm以下时，可以考虑对活检标本进行检查。