This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
All are true about Paget disease EXCEPT: 
Select and explain. 
A. 97% associated with underlying Invasive Carcinoma of breast, B. 50% are hormone receptor positive, C. Wedge or punch is biopsy taken from nipple for diagnosis, D. Underlying tumor lying within 2cm for the nipple
B: 50% are hormone receptor positive
Answer: B: 50% are hormone receptor positive 
Explanation: 50% are hormone receptor positive REF: Nearly 98% of mammary Paget disease cases are associated with an underlying carcinoma, either in situ (intraductal, 10%) or infiltrating cancer (90%) Scrape cytology has been suggested as a noninvasive and reliable, rapid diagnostic screening method for mammary Paget disease. Punch, wedge, or excisional biopsy of the lesional skin of the nipple-areola complex to include the dermal and subcutaneous tissue for detailed microscopic examination provides an adequate sample for the accurate diagnosis of mammary Paget disease In cases of positive estrogen and progesterone receptors in an underlying breast carcinoma, the overlying Paget disease is negative for these receptors.