Evaluation of mapping biopsies for extramammary Paget disease: A retrospective study - 12/05/18
, Takamichi Ito, MD, PhD a, Gaku Tsuji, MD, PhD a, b, Takeshi Nakahara, MD, PhD a, c, Akihito Hagihara, DMSc, MPH d, Masutaka Furue, MD, PhD a, b, c, Hiroshi Uchi, MD, PhD aAbstract |
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.
Le texte complet de cet article est disponible en PDF.Key words : complete removal, extramammary Paget disease, mapping biopsy, Mohs micrographic surgery, recurrence, surgery, surgical margin, white macule
Abbreviations used : EMPD, MMS
Plan
| Drs Kaku-Ito and Ito contributed equally to this article. |
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| Funding sources: Supported in part by grants from the National Cancer Center, Japan; Ministry of Education, Culture, Sports, Science and Technology; and Ministry of Health, Labor and Welfare, Japan. |
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| Conflicts of interest: None disclosed. |
Vol 78 - N° 6
P. 1171 - juin 2018 Retour au numéro
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