PAGET’S disease of nipple
Rare manifestation of breast cancer. Occurs in 1% to 4% of cases
Named after Sir James Paget, who was a British surgeon and surgical pathologist who found an association between breast cancer and scaly lesion of the nippple.
Pagets disease of the nipple Presents as a unilateral erythematous eruption with a scale crust with pruritis. These can be easily mistaken for eczema.
Pathogenesis:
The malignant cells fom the undrlying Ductal carcinoma in situ(DCIS) or an invasive carcinoma Extend via lactiferous duct into the surface of nipple. The basement membrane is not breached. once these malignant cells reach the surface of the nipple, the normal epithelial barrier is disrupted thereby allowing the extracellular fluid to seep into the epithelial surface.
Clinical features
Present as Crusts and scaly lesions on the nipple with pruritis. Pain can also be the initial manifestation.
Palpable mass is present in 50% to 60% of women with Paget disease, usually invasive carcinoma.
If no mass palpable, then the underling disease will be DCIS
Diagnosis: Scrape smears from the nipple can show evidence of malignant cells. However, biopsy is needed for confirmation.
Treatment:
Depends on the underlying condition( DCIS or invasive carcinoma) and managed accordingly.
click here to read PATHOLOGY OF INFILTRATING DUCT CARCINOMA- BREAST
click here to read PATHOLOGY OF MEDULLARY CARCINOMA- BREAST
