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Paget disease of breast

Poh Siang Ooi, Nani Draman, Siti Suhaila Mohd Yusoff, Wan Zainira Wan Zain, Dharmendra Ganasagaran, Hui Heng Chua
Mammary Paget's disease is clinically defined as skin inflammation of the nipple area and is an adenocarcinoma of the epidermis of the nipple. The pathogenesis of mammary Paget's disease is relatively unknown; nonetheless, there are two popular theories that support the underlying carcinoma and de novo carcinogenesis. For the attending medical practitioner, mammary Paget's disease poses a diagnostic and therapeutic dilemma, especially in the absence of a clinically palpable breast mass. We report a rare case of a 48-year-old Malay woman who presented at Hospital Universiti Sains Malaysia, Kelantan, Malaysia with the symptom of skin erosion on the left nipple and unresponsiveness to multiple topical treatments...
November 29, 2018: Korean Journal of Family Medicine
Kenichi Shibata, Shintaro Nozu, Takayuki Tanaka, Wataru Kimura
BACKGROUND: Recently, surgical stress due to breast cancer has been reduced, more so for elderly patients. However, an expanded resection is still required in some situations. CASE PRESENTATION: We present a case of a 90-year-old woman with a 15 × 15 cm2 erythema and localized skin ulceration with hemorrhage in her right breast. A punch biopsy indicated mammary Paget's disease. Computed tomography showed that the tumor was only located on the surface of the breast with no metastasis, including of the axillar lymph nodes...
November 16, 2018: Surgical Case Reports
Angel Fernandez-Flores, Itziar Eraña, Jesus Cuevas
BACKGROUND: Mammary Paget disease and extramammary Paget disease (EMPD) have different prognoses. Because they are indistinguishable on histopathological grounds, they must be distinguished on a topographical basis. OBJECTIVE: To study cases of Paget disease of the breast, which show similarities to EMPD. METHODS: Cases were selected by 2 different approaches: (1) those with an exceptionally good evolution and no evidence of subjacent tumor and (2) those expressing MUC5AC...
October 2018: American Journal of Dermatopathology
David L Wachter, Peter W Wachter, Peter A Fasching, Matthias W Beckmann, Carolin C Hack, Marc-Oliver Riener, Arndt Hartmann, Johanna D Strehl
CONTEXT: - Paget disease of the breast, in most cases, represents intraepidermal spread of ductal carcinoma in situ. Molecular subtypes of invasive carcinoma of the breast have prognostic and therapeutic significance and show characteristic distribution. Little is known about the distribution of molecular subtypes in Paget disease of the breast. OBJECTIVES: - To examine the distribution of molecular subtypes in Paget disease of the breast and to compare them to concurrent invasive carcinoma of the breast, if present...
August 20, 2018: Archives of Pathology & Laboratory Medicine
B Joel Tjarks, Amy M Kerkvliet, Ali D Jassim
Sebaceous carcinoma in situ is a poorly understood and ill-defined entity. In situ sebaceous carcinoma exhibits a similar location pattern to its invasive counterpart in that most commonly has a periorbital distribution. Review of the literature found only seven cases of extraocular sebaceous carcinoma in situ. We present a unique and challenging case of sebaceous carcinoma in situ masquerading both clinically and histologically as Paget's disease of the breast. A 61-year-old female presented to her dermatologist complaining of a 6 mm erythematous waxy papule on her medial right breast...
August 2018: South Dakota Medicine: the Journal of the South Dakota State Medical Association
J Wang, W J Yu, X Wang, X Wang, Y T Tian
Objective: The aim of this study was to explore the clinicopathologic characteristics and prognostic factors of Paget's disease. Methods: 137 patients with Paget's disease of the breast who were diagnosed in Cancer Hospital Chinese Academy of Medical Sciences between January 2007 and May 2016 were identified and included in the study, including 134 females and 3 males. Results: The average age at onset of the disease was 51.8 years(range, 27-78 years). Among the 137 patients, 7 cases were Paget's disease without any other underlying malignancy, who were alive during the follow-up period...
July 23, 2018: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
Biji Babu, Bhawna Dev, T Mohanapriya, C N Sai Shalini
Mammary Paget disease is an uncommon malignancy of the breast that presents with ulceration or eczema of the nipple and is almost always associated with an underlying breast carcinoma. This disease is most commonly seen in the fifth and sixth decades of life and is almost always unilateral. The diagnosis of mammary Paget disease is generally based on clinical findings, confirmed by histopathologic examination. Mammographic and ultrasonographic findings may be nonspecific for malignancy, with 50% of cases showing negative findings...
June 2018: Radiology Case Reports
Maimoona Siddique, M Khalid Nawaz, Humayun Bashir
Objectives: This study sought to determine the diagnostic yield of SPECT/CT in localizing axillary sentinel lymph nodes (SLNs) in early breast cancer patients where planar scintigraphy (PS) was equivocal or negative. Methods: Prospective analysis of early stage breast cancer patients with non-palpable axillary nodes undergoing SLN localization prior to nodal sampling for axillary staging. PS findings were categorized as: Category A: non-visualization of SLN; Category B: unusual uptake location; Category C: equivocal uptake / difficult interpretation...
2018: Asia Oceania Journal of Nuclear Medicine & Biology
M van der Linden, M S Schuurman, J Bulten, L F A G Massuger, J IntHout, M A van der Aa, J A de Hullu
BACKGROUND: Vulvar Paget disease (VPD) is extremely rare and thought to be associated with other malignancies. OBJECTIVES: To evaluate the risk of developing breast, intestinal and urological malignancies in patients with VPD compared with the general population, and in particular to focus on the risk of malignancy in patients with cutaneous noninvasive VPD. METHODS: Data on the oncological history of patients with any type of VPD between 2000 and 2015 were obtained from PALGA, a nationwide archive containing all pathology reports in the Netherlands...
June 19, 2018: British Journal of Dermatology
Adam R Schmitt, Beverly J Long, Amy L Weaver, Michaela E McGree, Jamie N Bakkum-Gamez, Jerry D Brewer, William A Cliby
OBJECTIVES: To identify the rates of associated and occult cancers in patients with extramammary Paget disease (EMPD) discovered using cancer screening methods at a tertiary medical center; to propose evidence-based cancer screening guidelines at the time of diagnosis of EMPD; and to clarify terminology associating EMPD with underlying malignancies. PATIENTS AND METHODS: A retrospective review of patients with histologically confirmed EMPD presenting for care at our institution between January 1, 1992, and December 31, 2015, was performed...
July 2018: Mayo Clinic Proceedings
L Yang, B R Fang, J Y He, X C Wang
Objective: To explore the establishment and application of three-dimensional model of deep inferior epigastric artery perforator flap based on computed tomography angiography (CTA). Methods: Six patients with breast absence after modified radical mastectomy because of breast cancer, 5 patients with congenital absence of vagina, and 6 patients with Paget's disease of penis and scrotum were hospitalized in our unit from January 2012 to April 2017. The size of wounds after excision of the lesion or that of flaps needed for reconstruction ranged from 17 cm×5 cm to 25 cm×9 cm...
May 20, 2018: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
Hideaki Ogata, Yukio Mitsuzuka, Naoko Honma, Miho Yoshida, Makoto Sumazaki, Fumi Saito, Masahiro Kobayashi, Kazutoshi Shibuya, Tetsuo Mikami, Hironori Kaneko
PURPOSE: Paget disease of the breast is a rare cancer that originates from the nipple-areolar complex. It is often overlooked and misdiagnosed as benign chronic eczema of the nipple. We aimed to retrospectively verify whether blood flow analysis using Doppler sonography was useful for detecting the presence of Paget disease. METHODS: In this retrospective study, 12 patients with pathologically proven unilateral nipple eczematous lesions (seven with Paget disease and five with simple dermatitis) were included...
2018: PloS One
Ikuko Hirai, Keiji Tanese, Yoshio Nakamura, Atsushi Otsuka, Yasuhiro Fujisawa, Yuki Yamamoto, Hiroo Hata, Taku Fujimura, Shigeto Matsushita, Koji Yoshino, Kaori Kameyama, Masayuki Amagai, Takeru Funakoshi
The human epidermal growth factor receptor 2 (HER2) is recognized as an oncogene as well as a therapeutic target in various cancers. Certain patients with advanced extramammary Paget's disease (EMPD) have also been reported to express HER2, which is therefore considered a therapeutic target for EMPD. However, an accurate methodology to determine HER2-positive EMPD has not been established. To assess the optimal methods for detection of HER2-positive EMPD, 73 EMPD samples were analyzed by immunohistochemical (IHC) staining, fluorescence in situ hybridization (FISH), and the HER2 testing algorithm for breast cancer of the American Society of Clinical Oncology/College of American Pathologists, which combined the results of IHC staining and FISH...
May 9, 2018: Medical Oncology
Yang Zhao, He-Fen Sun, Meng-Ting Chen, Shui-Ping Gao, Liang-Dong Li, Hong-Lin Jiang, Wei Jin
The objective of this study was to investigate the clinicopathological characteristics and survival outcomes of Paget disease (PD), Paget disease concomitant infiltrating duct carcinoma (PD-IDC), and Paget disease concomitant intraductal carcinoma (PD-DCIS). We identified 501,631 female patients from 2000 to 2013 in the Surveillance, Epidemiology, and End Results (SEER) database. These identified patients included patients with PD (n = 469), patients with PD-IDC (n = 1832), and patients with PD-DCIS (n = 1130) and infiltrating ductal carcinoma (IDC) (n = 498,076)...
June 2018: Cancer Medicine
A Gaurav, V Gupta, R Koul, S Dabas, R Sareen, K Geeta, V Arora, Purvish M Parikh, S Aggarwal
Paget's disease of the breast is a rare type of cancer of the nipple-areola complex and that is often associated with an underlying in situ or invasive carcinoma. Diagnosis and treatment of Paget's disease is controversial. Expert oncologists discuss on the update on the approaches of Paget's disease diagnosis and its treatment options. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at this practical consensus recommendations for the benefit of community oncologists...
April 2018: South Asian Journal of Cancer
M Vergine, A Musella, E Gulotta, F Frusone, Alberto De Luca, F Maceli, A Libia, P Benedetti Panici, M Monti
INTRODUCTION: Paget disease of the nipple in man is a very rare breast cancer, and there are not standard procedures or guidelines. In any cases, a Paget's disease could hide an invasive ductal breast cancer. CASE DESCRIPTION: We report the case of a 77-years old man affected by Alzheimer's disease, who presented to our attention because of an ulcerated palpable mass in the right nipple. A biopsy of the lesion showed "intra-epidermic proliferation of epitelioid cells, associated with linfo-plasmacellular infiltration of superficial dermis, compatible with Paget's disease (pTis)"...
March 2018: Il Giornale di Chirurgia
M-H Jegou, E Lorier-Roy
BACKGROUND: Paget's disease of the breast is rare, even more so when it occurs in a supernumerary breast since diagnosis is delayed due to lack of exploration and ignorance of the pathology of ectopic breast. Based on an original clinical case, we provide a clinical update concerning ectopic breast and ectopic carcinoma, including Paget's disease. PATIENTS AND METHODS: A 44-year-old woman had complained of pain in the area of her supernumerary breast for several months...
June 2018: Annales de Dermatologie et de Vénéréologie
Xiaoyuan Bao, Kexin Sun, Xin Tian, Qiongzhou Yin, Meng Jin, Na Yu, Hanfang Jiang, Jun Zhang, Yonghua Hu
BACKGROUND: This study was conducted to describe present and changing trends in surgical modalities and neoadjuvant chemotherapy (NACT) in female breast cancer patients in China from 2006 to 2015. METHODS: Data of 44 299 female breast cancer patients from 15 tertiary hospitals in Beijing were extracted from hospitalization summary reports. Surgeries were categorized into five modalities: breast-conserving surgery (BCS), simple mastectomy (SM), modified radical mastectomy (MRM), radical mastectomy (RM), and extensive radical mastectomy (ERM)...
June 2018: Thoracic Cancer
Kou Fujisawa, Motoi Kato, Tatsuki Kono, Hiroki Utsunomiya, Azusa Watanabe, Shoji Watanabe
Nipple adenoma is an uncommon proliferative process of the breast and predominantly occurs in women aged 40-50. Its incidence is extremely low in men, and it has not been reported in a boy. Although nipple adenoma is rare and benign, being familiar with it is important because it clinically resembles Paget disease and histologically adenocarcinoma. We report a case of nipple adenoma in a boy.
May 2018: Pediatric Dermatology
Fernando Mota, Miguel Horta, Claudia Marques, Susan Foreid, Manuela Selores
Extramammary Paget disease of the vulva is a rare condition that accounts for only 1-2% of vulvar malignancies and represents a frequent cause of misdiagnosis. It is most commonly seen in postmenopausal women. Clinically it is similar to Paget disease of the breast, appearing as red, well-demarcated eczematoid lesions, with slightly raised edges. A high degree of clinical suspicion is very important when evaluating these lesions in order to avoid misdiagnosis and delay of effective treatment. We present a case of vulvar Paget disease treated with vulvectomy...
October 15, 2017: Dermatology Online Journal
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