Updated: 11/8/2019

Paget Breast Disease

Topic
Review Topic
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Evidence
2
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Snap Shot
  • A 78-year-old women presents with a scaly, eczematous rash involving and surrounding the nipple.
Introduction
  • Rare (1% of breast cancers)
  • Underlying ductal carcinoma (DCIS or IDC) almost always present
    • unlike Paget's disease of the vulva
Presentation
  • Presents with dermatitis (erythematous, scaly, and eczema-like) or pigmented (melanoma-like) lesion on the nipple or areola 
  • Does not heal with typical treatments for eczema, such as topical steroids
Evaluation
  • Diagnose with biopsy and mammogram (to look for an underlying cancer)
  • Biopsy will show clear cells with large, pleomorphic nuclei that spread individually into the epidermis ("pagetoid")
Treatment
  • Excision and radiation
 

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