title: Paget disease of the breast: analysis of 41 patients.
abstract: 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. Thirty-seven percent 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 rate.
authors.affiliation: Department of General Surgery, Providence Hospital & Medical Centers, Southfield, Michigan 48075, USA.
authors.forename: W
authors.initials: W
authors.lastname: Fu
authors.forename: V K
authors.initials: VK
authors.lastname: Mittel
authors.forename: S C
authors.initials: SC
authors.lastname: Young
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D018450:Disease Progression; D005260:Female; D006801:Humans; D008875:Middle Aged; D010144:Paget's Disease, Mammary / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D012042:Registries; D012189:Retrospective Studies; D016019:Survival Analysis