Skip to main content

Paget’s Disease of the Breast

  • Chapter
  • First Online:
Breast Disease

Abstract

Paget’s disease of the breast is a rare breast tumor that was first identified by Sir James Paget in 1874. It is characterized by eczema-form changes accompanied with erosion and ulceration of the nipple and areolar epidermis. It is mostly correlated with ductal carcinoma in situ (DCIS); additionally, it can be accompanied by invasive ductal carcinoma (IDC). The diagnosis is determined upon microscopically observing Paget cells in a skin biopsy. The width of the lesion is evaluated via mammography and 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 having axillary metastases are the treatment alternatives to breast-preserving surgery or mastectomy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 219.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  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. Desai DC, Brennan Jr EJ, Carp NZ. Paget’s disease of the male breast. Am Surg. 1996;62(12):1068–72.

    CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  4. Serour F, Birkenfeld S, Amsterdam E, Treshchan O, Krispin M. Paget’s disease of the male breast. Cancer. 1988;62(3):601–5.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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. Jamali FR, Ricci Jr A, Deckers PJ. Paget’s disease of the nipple-areola complex. Surg Clin N Am. 1996;76:365.

    Article  CAS  PubMed  Google Scholar 

  8. Kollmorgen DR, Varanasi JS, Edge SB, Carson 3rd WE. Paget’s disease of the breast: a 33-year experience. J Am Coll Surg. 1998;187:171.

    Article  CAS  PubMed  Google Scholar 

  9. Sagebiel RW. Ultrastructural observations on epidermal cells in Paget’s disease of the breast. Am J Pathol. 1969;57:49.

    CAS  PubMed  PubMed Central  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  12. Vanstapel MJ, Gatter KC, De Wolf-Peeters C, Millard PR, Desmet VJ, Mason DY. Immunohistochemical study of mammary and extra-mammary Paget’s disease. Histopathology. 1984;8:1013.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  14. Chaudary MA, Millis RR, Lane EB, Miller NA. Paget’s disease of the nipple: a ten year review including clinical, pathological, and immunohistochemical findings. Breast Cancer Res Treat. 1986;8:139.

    Article  CAS  PubMed  Google Scholar 

  15. Kobayashi TK, Ueda M, Nishino T, Kibe S, Higashida T, Watanabe S. Scrape cytology of pemphigus vulgaris of the nipple, a mimicker of Paget’s disease. Diagn Cytopathol. 1997;16:156.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  18. Tohno E, Cosgrove DO, Sloane JP. Ultrasound diagnosis of breast disease. London: Churchill Livingstone; 1994. p. 76–178.

    Google Scholar 

  19. Sakorafas GH, Blanchard K, Sarr MG, Farley DR. Paget’s disease of the breast. Cancer Treat Rev. 2001;27:9–18.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  21. Friedman EP, Hall-Craggs MA, Mumtaz H, Schneidau A. Breast MR. The appearance of normal and abnormal nipple. Clin Radiol. 1997;52:854–61.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  23. Yao D, Hoda S, Ying L, Rosen P. Intraepithelial cytokeratin 7 immunoreactive cells in non-neoplastic nipple represents interepithelial extension of lactiferous duct cells (abstract). Mod Pathol. 2001;14:42A.

    Article  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Abdullah İğci MD, FACS .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

İğci, A., Aksakal, N., Özkurt, E. (2016). Paget’s Disease of the Breast. In: Aydiner, A., İgci, A., Soran, A. (eds) Breast Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-26012-9_25

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-26012-9_25

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-26010-5

  • Online ISBN: 978-3-319-26012-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics