Paget's disease of the breast
From Wikipedia, the free encyclopedia
| Paget's disease of the breast | |
|---|---|
| Classification and external resources | |
 Micrograph of Paget's disease. H&E stain. |
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| ICD-10 | C50. |
| ICD-9 | 174 |
| ICD-O: | M8540/3 |
| DiseasesDB | 9500 |
| eMedicine | derm/305 |
| MeSH | D010144 |
Paget's disease of the breast (also known as Paget's disease of the nipple [1]) is a malignant condition that outwardly may have the appearance of eczema, with skin changes involving the nipple of the breast.
The condition occurs when Paget's cells, which are large and irregular, form in the skin of the nipple. Although Paget believed the cells were not cancerous, it was later proved that the cells were themselves malignant, in addition to indicating underlying breast cancer.[2] Since the condition is often innocuous and limited to a surface appearance, it is sometimes dismissed, despite the fact that it is indicative of a condition (breast cancer) that may prove fatal if left untreated.[3]
Extramammary Paget's disease (EMPD) has the same histologic features as Paget's disease of the breast but different locations.
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[edit] Symptoms
The first symptom is usually an eczema-like rash, usually only affecting one nipple. The skin of the nipple and areola may be red, itchy and inflamed. Some women have an itching or burning sensation. Fluid (discharge) may leak from the abnormal area of cells.[4] The nipple may turn inwards (be inverted). There may or may not be a lump in the breast, and there may be redness, oozing and crusting, and a sore that does not heal.
[edit] Diagnosis
Recommended tests are a mammogram and a biopsy to confirm the diagnosis, and cytopathology may also be helpful.
[edit] Treatment
Paget's disease of the breast is a type of cancer of the breast. Treatment usually involves a lumpectomy[citation needed] or mastectomy[5] to surgically remove the tumour. Chemotherapy and/or radiotherapy may be necessary.
[edit] Prognosis
If lymph nodes are negative the five year and ten year survival is 85% and 79% respectively. If the lymph nodes are positive it is 32% and 28%.[6]
[edit] Epidemiology
Paget disease accounts for approximately 2% of breast cancer and typically affects postmenopausal women.[6]
[edit] History
The condition is named after Sir James Paget, an English surgeon who first described it in 1875. Several other diseases are also named after Paget.
[edit] References
- ^ Dalberg K, Hellborg H, Wärnberg F (September 2008). "Paget's disease of the nipple in a population based cohort". Breast Cancer Res. Treat. 111 (2): 313–9. doi:. PMID 17952590. http://dx.doi.org/10.1007/s10549-007-9783-5.
- ^ Thin, G. On the connection between disease of the nipple and areola and tumors of the breast. Trans Pathol Soc Lond 1881; 32:218.
- ^ Paget's Disease of the Nipple by Kenneth Blank, MD and John Han-Chih Chang, MD, at OncoLink.com. November 1, 2001
- ^ "Paget Disease of the Nipple: Q & A - National Cancer Institute". http://www.cancer.gov/cancertopics/factsheet/Sites-Types/paget-breast. Retrieved 2009-03-23.
- ^ Kollmorgen DR, Varanasi JS, Edge SB, Carson WE (August 1998). "Paget's disease of the breast: a 33-year experience". J. Am. Coll. Surg. 187 (2): 171–7. PMID 9704964. http://linkinghub.elsevier.com/retrieve/pii/S1072-7515(98)00143-4.
- ^ a b Ing S (January 2008). "Dermacase. Paget disease". Can Fam Physician 54 (1): 33, 41. PMID 18208950.
[edit] External links
- National Cancer Institute fact sheet
- Snopes
- Overview at mayoclinic.com
- Image at medctr.ucla.edu
- Breast Cancer Network of Strength - Information on Paget's Disease
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