Paget’s Disease of the Breast

• Diagnosis can be confirmed with a punch biopsy the nipple areolar complex.
• Classically present with eczematous changes of the nipple which can progress to bleeding and ulceration.
• More than 90% of patients have underlying carcinoma (in situ or invasive)
• Cancer involving skin and nipple.
• Treatment: mastectomy traditionally.  But could be nipple areolar excision with central lumpectomy with radiation therapy (breast conservation therapy) – similar results.
• 50% of patients with Paget’s disease will present with palpable mass.
• May be a role for MRI – deeper breast tissue disease may be missed radiographically and MRI can help detect.

What is breast conservation therapy?

A lesser amount of surgery than mastectomy.  Lumpectomy

Paget’s diease of the breast is also known as?

• Paget’s disease of the nipple
• Mammary paget disease