Evaluation of mapping biopsies for extramammary Paget disease: A retrospective study - 12/05/18
Abstract |
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 numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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