Diagnostic Objectively, eczematoid changes of the nipple-areola complex are common. St. Bartholomew Hospital Reports. With a mean follow-up of 32 months (range, 4-109 months), there has been only 1 recurrence (7%), which was treated successfully by modified radical mastectomy. Twenty-four (69%) patients had Paget's disease without a palpable mass in the breast; eleven (31%) presented with a palpable mass and Paget's disease of the nipple. The rate of expression of these biologic markers was similar in both the Paget cells and the underlying intraductal and/or ductal carcinoma cells. A therapeutic option of conservative surgical intervention and follow-up is described for five of these select patients, all of whom are presently without evidence of disease with an average follow-up of 50 months (range, 30–69 months).Background: Management of patients with mammary Paget's disease is controversial; recent recommendations range from primary radiotherapy to modified radical mastectomy.

Vous bénéficiez d'un droit d'accès et de rectification de vos données personnelles, ainsi que celui d'en demander l'effacement dans les limites prévues par la loi. La mammographie peut être normale dans 50 % des cas.

Ten patients had subareolar cancers that directly involved the nipple or areola; 5 patients had Paget disease of the nipple. In the 24 women without breast palpable mass, 17 (71%) had a normal mammogram, 12 (50%) had carcinoma with an invasive component, 14 (58%) had a cancer at a distance from the nipple, 17 (71%) had a multifocal carcinoma. CEA was also present in the cells and secretions of normal eccrine and apocrine glands. The clinical, pathologic, and mammographic records of 58 patients who had biopsy-proved Paget disease of the nipple were retrospectively reviewed. The rate of ipsilateral breast recurrence will be similar to that seen with peripheral breast cancers. Peak incidence of the disease is between 50 and 70 years of age. An underlying carcinoma was found in 60 cases (98.4%), atypical epithelial hyperplasia in one. The underlying disease is of high grade and is frequently c-erb-B2 positive with a resulting poor prognosis. Concordance of c-erbB-2 antigen staining between the underlying breast carcinomaand the pagetoid component was observed in 12 cases. Aggressive local and systemic treatment would seem to be merited.At 5-year follow-up, patients with Paget disease of the breast who were treated with breast-conserving surgery (BCS) and radiotherapy (RT) had excellent results. Mammogram is of limited value in management of Paget's disease of the breast for women without breast palpable mass; it can not predict the site of malignancy, nor the invasive component.Paget's disease of the breast is a rare disorder of the nipple-areola complex that is often associated with an underlying in situ or invasive carcinoma. The survival of patients with invasive disease was compared with matched controls without Paget disease. Conclusions: Although some patients with Paget's disease might be well treated by breast conservation therapy, many patients have underlying multifocal carcinoma (including invasive cancer), which can be inapparent by examination and mammography. La maladie de Paget du mamelon, est une pathologie rare qui touche les femmes à partir de 40 ans. Ninety-four percent of patients underwent complete or partial excision of the nipple-areola complex and all patients received a median external beam irradiation dose of 50 Gy (range, 45-54 Gy) to the whole breast. Elle est appelée la maladie de Paget.

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Dans la majorité des cas, un cancer du sein sous-jacent est retrouvé.

Patients with Paget's disease and a palpable mass have a much greater incidence of invasive cancer, multifocal lesions, and positive lymph nodes, and have worse survival. Cosmetic results are satisfactory to excellent, as judged by both the patients and the surgeons. As a consequence, cone excision of the nipple would have resulted in incomplete excision in 75% of cases. In one patient, there was a definite disparity in the antigenic profile; in another patient, this was dissimilar because of very focal staining in one site. Diseases oof the breast. Our observations confirm that Paget's cells are of glandular origin.Six cases of Paget's disease of the nipple without clinical or mammographic evidence of a breast mass are described, two without underlying carcinoma of duct origin, and four with very limited duct carcinoma in situ of the most distal lactiferous ducts.

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