title: Feasibility of breast conserving surgery for Paget's disease.
abstract: BACKGROUND
  The standard treatment for Paget's disease of the breast is mastectomy. Since it is frequently associated with underlying carcinoma, many surgeons are reluctant to choose breast conserving surgery for Paget's disease.
  
  
  METHODS
  We retrospectively analyzed a series of 59 patients with Paget's disease who had undergone mastectomy at the National Cancer Center Hospital between 1963 and 2009.
  
  
  RESULTS
  In 55 of 59 cases (93%) there was underlying carcinoma in the ipsilateral breast. Clinically, 27 (46%) patients had no evidence of other tumors, but 23 (85%) had underlying histopathologically confirmed carcinoma. Based on the data from this subset, cone excision with a 3-cm radius and a 4-cm radius could completely resect any underlying malignancy in 74% and 85% of patients, respectively.
  
  
  CONCLUSIONS
  As Paget's disease is frequently accompanied by underlying intraductal and/or invasive carcinoma, patients should be carefully selected for breast conserving surgery.
authors.affiliation: Breast Cancer Group, Surgical Oncology Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Onoe
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Nobuko
authors.initials: N
authors.lastname: Tamura
authors.forename: Tomoya
authors.initials: T
authors.lastname: Nagao
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kuno
authors.forename: Takashi
authors.initials: T
authors.lastname: Hojo
authors.forename: Sadako
authors.initials: S
authors.lastname: Akashi-Tanaka
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Tsuda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007564:Japan; D015412:Mastectomy, Segmental / Q000706:statistics & numerical data*; D008875:Middle Aged; D010144:Paget's Disease, Mammary / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome