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Breast Disease pp 359-363 | Cite as

Paget’s Disease of the Breast

  • Abdullah IgciEmail author
  • Nihat Aksakal
  • Enver Özkurt
Chapter

Abstract

Paget’s disease of the breast is a rare breast tumor that was first identified by Sir James Paget in 1874. Paget’s disease of the breast is characterized by eczema-form changes accompanied by erosion and ulceration of the nipple and areolar epidermis and is mostly correlated with ductal carcinoma in situ (DCIS). Additionally, Paget’s disease of the breast can be accompanied by invasive ductal carcinoma (IDC). The diagnosis of Paget’s disease of the breast is determined upon microscopically observing Paget cells in a skin biopsy. The width of the lesion is evaluated via mammography and magnetic resonance imaging (MRI) in patients for whom breast-preserving surgery is planned. Depending on the extent of the lesion, sentinel lymph node biopsy and axillary curettage for those with axillary metastases are the treatment alternatives to breast-preserving surgery or mastectomy.

Keywords

Paget carcinoma Ulceration of the nipple Eczematous lesions Central resection 

References

  1. 1.
    Paget J. On disease of the mammary areola preceding cancer of the mammary gland. St Bartholomew Hosp Rep. 1874;10:87–9.Google Scholar
  2. 2.
    Desai DC, Brennan EJ Jr, Carp NZ. Paget’s disease of the male breast. Am Surg. 1996;62(12):1068–72.PubMedGoogle Scholar
  3. 3.
    Caliskan M, Gatti G, Sosnovskikh I, Rotmensz N, Botteri E, Musmeci S, et al. Paget’s disease of the breast: the experience of the European Institute of Oncology and review of the literature. Breast Cancer Res Treat. 2008;112:513.CrossRefGoogle Scholar
  4. 4.
    Serour F, Birkenfeld S, Amsterdam E, Treshchan O, Krispin M. Paget’s disease of the male breast. Cancer. 1988;62(3):601–5.CrossRefGoogle Scholar
  5. 5.
    Ortiz-Pagan S, Cunto-Amesty G, Narayan S, Crawford S, Derrick C, Larkin A, et al. Effect of Paget’s disease on survival in breast cancer: an exploratory study. Arch Surg. 2011;146(11):1267–70.CrossRefGoogle Scholar
  6. 6.
    Kaelin CM. Paget’s disease. In: Harris JR, Lippman ME, Morrow M, Osborne CK, editors. Diseases of the breast. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2004. p. 1007–14.Google Scholar
  7. 7.
    Jamali FR, Ricci A Jr, Deckers PJ. Paget’s disease of the nipple-areola complex. Surg Clin N Am. 1996;76:365.CrossRefGoogle Scholar
  8. 8.
    Kollmorgen DR, Varanasi JS, Edge SB, Carson WE 3rd. Paget’s disease of the breast: a 33-year experience. J Am Coll Surg. 1998;187:171.CrossRefGoogle Scholar
  9. 9.
    Sagebiel RW. Ultrastructural observations on epider-mal cells in Paget’s disease of the breast. Am J Pathol. 1969;57:49.PubMedPubMedCentralGoogle Scholar
  10. 10.
    Fu W, Lobocki CA, Silberberg BK, Chelladurai M, Young SC. Molecular markers in Paget disease of the breast. J Surg Oncol. 2001;77:171.CrossRefGoogle Scholar
  11. 11.
    Kirkham N, Berry N, Jones DB, Taylor-Papadimitriou J. Paget’s disease of the nipple. Immunohistochemical localization of milk fat globule membrane antigens. Cancer. 1985;55:1510.CrossRefGoogle Scholar
  12. 12.
    Vanstapel MJ, Gatter KC, De Wolf-Peeters C, Millard PR, Desmet VJ, Mason DY. Immunohistochemical study of mammary and extra-mammary Paget’s dis-ease. Histopathology. 1984;8:1013.CrossRefGoogle Scholar
  13. 13.
    Franceschini G, Masetti R, D’Ugo D, Palumbo F, D’Alba P, Mulè A, et al. Synchronous bilateral Paget’s disease of the nipple associated with bilateral breast carcinoma. Breast J. 2005;11:355.CrossRefGoogle Scholar
  14. 14.
    Chaudary MA, Millis RR, Lane EB, Miller NA. Paget’s disease of the nipple: a ten year review including clinical, pathological, and immunohisto-chemical findings. Breast Cancer Res Treat. 1986;8:139.CrossRefGoogle Scholar
  15. 15.
    Kobayashi TK, Ueda M, Nishino T, Kibe S, Higashida T, Watanabe S. Scrape cytology of pemphigus vul-garis of the nipple, a mimicker of Paget’s disease. Diagn Cytopathol. 1997;16:156.CrossRefGoogle Scholar
  16. 16.
    Günhan-Bilgen I, Oktay A. Paget’s disease of the breast: clinical, mammographic, sonographic and pathologic findings in 52 cases. Eur J Radiol. 2006;60(2):256–63.CrossRefGoogle Scholar
  17. 17.
    Ceccherini AF, Evans AJ, Pinder SE, Wilson AR, Ellis IO, Yeoman LJ. Is ipsilateral mammography worthwhile in Paget’s disease of the breast? Clin Radiol. 1996;51:35.CrossRefGoogle Scholar
  18. 18.
    Tohno E, Cosgrove DO, Sloane JP. Ultrasound diag-nosis of breast disease. London: Churchill Livingstone; 1994. p. 76–178.Google Scholar
  19. 19.
    Sakorafas GH, Blanchard K, Sarr MG, Farley DR. Paget’s disease of the breast. Cancer Treat Rev. 2001;27:9–18.CrossRefGoogle Scholar
  20. 20.
    Tilanus-Linthorst MM, Obdeijn AI, Bontenbal M, Oudkerk M. MRI in patients with axillary metastases of occult breast carcinoma. Breast Cancer Res Treat. 1997;44:179–82.CrossRefGoogle Scholar
  21. 21.
    Friedman EP, Hall-Craggs MA, Mumtaz H, Schneidau A, Breast MR. The appearance of normal and abnor-mal nipple. Clin Radiol. 1997;52:854–61.CrossRefGoogle Scholar
  22. 22.
    Gillett CE, Bobrow LG, Millis RR. S100 protein in human mammary tissue immunoreactivity in breast carcinoma, including Paget’s disease of the nipple, and value as a marker of myoepithelial cells. J Pathol. 1990;160:19.CrossRefGoogle Scholar
  23. 23.
    Yao D, Hoda S, Ying L, Rosen P. Intraepithelial cyto-keratin 7 immunoreactive cells in non-neoplastic nip-ple represents interepithelial extension of lactiferous duct cells (abstract). Mod Pathol. 2001;14:42A.CrossRefGoogle Scholar
  24. 24.
    Zakaria S, Pantvaidya G, Ghosh K, Degnim AC. Paget’s disease of the breast: accuracy of preoperative assessment. Breast Cancer Res Treat. 2007;102:137.CrossRefGoogle Scholar
  25. 25.
    Solin LJ, Kurtz J, Fourquet A, Amalric R, Recht A, Bornstein BA, et al. Fifteen-year results of breast-conserving surgery and definitive breast irradiation for the treatment of ductal carcinoma in situ of the breast. J Clin Oncol. 1996;14:754.CrossRefGoogle Scholar
  26. 26.
    Sukumvanich P, Bentrem DJ, Cody HS 3rd, et al. The role of sentinel lymph node biopsy in Paget’s disease of the breast. Ann Surg Oncol. 2007;14:1020.CrossRefGoogle Scholar
  27. 27.
    Laronga C, Hasson D, Hoover S, et al. Paget’s disease in the era of sentinel lymph node biopsy. Am J Surg. 2006;192:481.CrossRefGoogle Scholar
  28. 28.
    Paone JF, Baker RR. Pathogenesis and treatment of Paget’s disease of the breast. Cancer. 1981;48:825.CrossRefGoogle Scholar
  29. 29.
    Eusebio RB, Deckers PJ. Paget’s disease of the nipple-areola complex: a plea for conservatism. Contemp Surg. 1992;40:13.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Istanbul Medical FacultyIstanbul UniversityIstanbulTurkey
  2. 2.Department of General SurgeryIstanbul Medical Faculty, Istanbul UniversityIstanbulTurkey

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