ABSTRACT: Paget Disease of the Breast: Analysis of 41 Patients
[07/30/2001; American Journal of Clinical Oncology]
The treatment for the patients with Paget disease of the breast
is controversial. This review of its natural history, treatment
approach, and clinical outcome will help to formulate treatment.
Forty-one patients with a diagnosis of Paget disease of the breast
were retrospectively reviewed at Providence Hospital & Medical
Centers from 1980 to 1999.
Ninety-eight percent of patients had
underlying carcinoma (ductal carcinoma in situ and/or invasive
ductal cancer). Patients with a palpable mass have a much higher
incidence of invasive ductal cancer, positive lymph node, and
a worse survival rate. The median length of follow-up was 42
months (range: 6-200 months).
Twenty-seven percent of patients
(11/41) had conservative operations, including 1 patient with
a palpable mass; 10 patients with no palpable mass; and 3 patients
with recurrence after conservative operation.
of patients received adjuvant therapy. Paget disease of the breast
has very high incidence of underlying carcinoma (100% in a palpable
mass, 96% in nonpalpable mass). Patients with a palpable mass
have a worse survival than do patients with nonpalpable mass.
Conservative operation should cautiously be selected even for
patients with no palpable mass because of a higher recurrence
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