title: The role of sentinel lymph node biopsy in Paget's disease of the breast.
abstract: BACKGROUND
  Sentinel lymph node (SLN) biopsy has become a standard of care for axillary lymph node staging in breast cancer and appears suitable for virtually all patients with clinically node-negative (cN0) invasive disease. However, its role in Paget's disease of the breast, a condition in which invasion may or may not be present, remains undefined.
  
  
  METHODS
  Among 7,083 consecutive SLN biopsy procedures, we retrospectively identified 39 patients with Paget's disease of the breast. Nineteen patients had no associated clinical/radiographic features ("Paget's only"), and 20 patients had associated clinical/radiographic findings ("Paget's with findings").
  
  
  RESULTS
  The mean ages for the Paget's alone and with findings groups were 63.6 and 49.6 years, respectively. The use of breast conservation therapy was 32% in the Paget's alone group and 10% in the Paget's with findings group. Invasive carcinoma was found in 27% of patients in the Paget's alone group and 55% of patients in the Paget's with findings group. The success rate of SLN biopsy was 98%, and the mean number of SLNs removed was 3 in both groups. In the entire cohort of Paget's disease, 28% (11/39) of the patients had positive SLNs (11%, Paget's alone; 45%, Paget's with findings).
  
  
  CONCLUSIONS
  In our "Paget's only" cohort, invasive cancer was found in 27% of cases and positive SLNs in 11%. SLN biopsy should be considered in all patients with Paget's disease of the breast, whether associated clinical/radiographic findings are present.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Gynecologic Oncology, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: P
authors.initials: P
authors.lastname: Sukumvanich
authors.forename: D J
authors.initials: DJ
authors.lastname: Bentrem
authors.forename: H S
authors.initials: HS
authors.lastname: Cody
authors.forename: E
authors.initials: E
authors.lastname: Brogi
authors.forename: J V
authors.initials: JV
authors.lastname: Fey
authors.forename: P I
authors.initials: PI
authors.lastname: Borgen
authors.forename: M L
authors.initials: ML
authors.lastname: Gemignani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010144:Paget's Disease, Mammary / Q000556:secondary*; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy