Micrograph of<unk> 's<unk> . H&E stain. Recommended tests are a mammogram and a biopsy to confirm the diagnosis, and cytopathology may also be helpful.<unk> 's<unk>  is difficult to diagnose due to its resemblance to dermatitis and eczema; even in patients after ductal carcinoma in situ surgery. Eczema tends to affect the areola first, and then the nipple, whereas<unk> 's spreads from the nipple. During a physical examination, the doctor examines the unusual areas of the breast, especially the appearance of the skin on and around the nipples and feeling for any lumps or areas of thickening. The most common test used to diagnose<unk> 's<unk>  is the biopsy, removal of a tissue sample from the affected area which is then examined under the microscope by a pathologist, who distinguishes<unk>  cells from other cell types by staining tissues to identify specific cells (immunohistochemistry). CD138 and p53 can be used, both being positive in<unk> 's<unk> , and negative in Toker cells, which are normal epithelial cells with clear cytoplasm that can be difficult to distinguish from<unk> 's<unk> . Besides,<unk>  cells stain positive for CK7 in >90% of the cases. Similarly, GATA3 and HER-2 are expressed in around 90% of the cases, and can be used for the confirmation, including CK7 negative<unk><unk> . Samples of nipple discharge may also be examined under the microscope to determine whether<unk>  cells are present. Imprint or scrape cytopathology may be useful: scraping cells from the affected area, or pressing them onto a glass slide to be examined under the microscope. On average, a woman may experience signs and symptoms for six to eight months before a diagnosis is made.
Paget's disease of the breast
Hereditary lobular breast cancer
Breast eczema
Adenomyoepithelioma of the breast
Medullary breast carcinoma
Mucinous carcinoma of the breast
Duct ectasia of breast
Papillomatosis of breasts