The objective: is to determine the contribution of breast imaging in the diagnosis of Paget's disease, to describe the aspects and the radiological particularities in conventional imaging, in MRI and to know thetherapeutic management. Materials and methods Clinical, radiological (mammography, ultrasound and MRI), and histological data were analyzed in 23 female patients presenting Paget disease of the breast. The criteria for analysis in MRI were the following: morphology of the areola-nipple plaque (thickening, regularity of the contour) and the type of enhancement after injection of contrast medium (signal intensity/time curve), detection of abnormal enhancing in the mammary gland, and ganglion areas. Results: Five of the patients do not presented a palpable mass or a suspicious anomaly on mammography. On MRI, the areola-nipple plaque was morphologically abnormal in four cases, with suspicious enhancement in two cases (two cases of ductal carcinoma in situ) and normal enhancement in two cases (one case of ductal carcinoma in situ). In the two other cases, the areola-nipple plaque was normal (one case of ductal carcinoma in situ). Distant abnormal enhancement of the areola-nipple plaque was noted in two cases (one case of ductal carcinoma in situ and one benign lesion). Conclusion the MRI aspect of the areola-nipple
plaque in Paget disease shows little concordance with the histological results. MRI can be useful in detecting distant lesions when there is no clinical sign nor a suspicious mammography.