Breast: Paget’s Disease of the Breast

Paget’s Disease of the Breast (Paget’s Disease of the Nipple)

Definition

  • Definition: Scaly Skin Changes of the Nipple/Areola Due to Underlying Breast Cancer
  • Paget Cells – Malignant Adenocarcinoma Cells within the Epidermis of the Nipple
  • Derives from Underlying Breast Cancer with Malignant Ductal Cells Migrating Through the Ductal System to the Nipple
    • Indicates Underlying Ductal Carcinoma In Situ (DCIS) or Invasive Ductal Carcinoma (IDC) in 85-88% of Cases

Presentation

  • Eczematoid Scaling of the Nipple-Areola Complex
  • May Have Vesicles or Ulcerations
  • Copious Clear-Yellow Exudate
  • Pain & Burning

Diagnosis

  • Should Undergo a Bilateral Diagnostic Mammogram to Evaluate Underlying Lesion
  • Biopsy:
    • Full Thickness Skin Biopsy of the Nipple – To Diagnose Paget’s Disease
    • Core Needle Biopsy (CNB) – To Diagnose the Primary Lesion

Treatment

  • Standard Treatment: Simple Mastectomy & SLNB
  • May Consider Breast-Conserving Treatment in Select Cases

Paget’s Disease 1

References

  1. Chu L. Wikimedia Commons. (License: Public Domain)