title: Paget disease of the breast--an easily overlooked disease?
abstract: OBJECTIVE
  Paget disease of the breast has long been recognized as a distinct clinical disease. The clinical manifestations and outcomes of Paget disease of the breast were reviewed to understand its earlier diagnostic clues and achieve an optimal treatment plan. Patients and Methods Thirty-one patients with Paget disease of the breast were included in this study. The postoperative outcomes and possible related prognostic factors were reviewed and analyzed.
  
  
  RESULTS
  The 5-year overall survival was 69%. Nineteen patients (61%, Group A) did not have a palpable breast mass and 12 patients (39%, Group B) had a palpable breast mass. There was significant difference (P < 0.01) in the 5-year overall survival between Group A (94%) and Group B (19%). Group A patients had significantly higher incidences of underlying noninvasive breast carcinoma (73% vs. 8%, P < 0.01) and n0 lymph nodes status (84%vs. 50%, P = 0.043) than those of Group B.
  
  
  CONCLUSIONS
  Paget disease of the breast without a palpable breast mass carries a more favorable prognosis. Patients with any nipple complaints deserve a detailed evaluation even in the absence of a palpable breast mass in order not to overlook a favorable disease.
authors.affiliation: Department of General Surgery, Colon and Rectal Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung, Taiwan. smsheen@yahoo.com
authors.forename: S M
authors.initials: SM
authors.lastname: Sheen-Chen
authors.forename: H S
authors.initials: HS
authors.lastname: Chen
authors.forename: W J
authors.initials: WJ
authors.lastname: Chen
authors.forename: H L
authors.initials: HL
authors.lastname: Eng
authors.forename: C W
authors.initials: CW
authors.lastname: Sheen
authors.forename: F F
authors.initials: FF
authors.lastname: Chou
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010144:Paget's Disease, Mammary / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D011379:Prognosis; D016019:Survival Analysis