Practical consensus recommendatons for Paget’s disease in breast cancer

Gaurav, Agarwal; Gupta, Vikas; Koul, Rakesh; Dabas, Surender; Sareen, Rateesh; Geeta, Kekre; Arora, Vijay K.; Parikh, Purvish M.; Aggarwal, Sandeep

doi:10.4103/sajc.sajc_107_18

Cited by 16 publications

(21 citation statements)

References 35 publications

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“…MPD is a rare clinical entity, representing 1% to 3% of breast tumors [6]. MPD was first reported in 1856, by Velpau, when describing an eczematous lesion on the nipple's skin [7]. Later in 1874, Sir James Paget established an association between the presence of malignancy in the breast and dermatological changes in the nipple [3,8,9].…”

Section: Discussionmentioning

confidence: 99%

Invasive Mammary Paget Disease with no Underlying Breast Carcinoma

Raquel¹,

María²,

Fernando³

et al. 2021

Case Rep Imag Surg

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Introduction: Mammary Paget disease (MPD) usually presents as a neoplasm confined to the epithelium with underlying in situ or infiltrating breast carcinoma. Invasive Mammary Paget Disease with no underlying breast carcinoma (InvMPD) is a rare subtype of MPD that manifests as dermatosis on the nipple's skin. We present a case clinical, radiological, and histopathological characteristics of an InvMPD in a female patient.Case presentation: A 42-year-old woman with a family history of breast cancer consulted with an erythematous lesion on the nipple's skin. Imaging studies revealed a circumscribed lesion consistent with fibroadenoma, which was confirmed by histology. Incisional biopsy and nipple excision revealed an InvPMD. Discussion: MPD is a rare neoplasm that represents 1-3% of all primary breast malignancies. Less frequently, MPD can rarely develop dermal infiltration without underlying carcinoma (invMPD). Five cases of InvMPD have been reported in the literature; therefore, we report the sixth case of InvMPD in a 42-year-old woman. Conclusion:InvMPD is a rare clinical entity that should be considered in cases with no carcinoma in situ or invasive in breast tissue after an extensive radiological and histologically sampling of the nipple is performed.

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Section: Discussionmentioning

confidence: 99%

Invasive Mammary Paget Disease with no Underlying Breast Carcinoma

Raquel¹,

María²,

Fernando³

et al. 2021

Case Rep Imag Surg

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“…Pueden encontrarse micro calcificaciones "en perdigonada" de la región areolar. En diversos estudios, casi la mitad de los pacientes tienen mamografías normales [1][2][3][4][5][6][7].…”

Section: Discussionunclassified

Caso Clínico: Enfermedad de Paget del Pezón

et al. 2019

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REVISTA MÉDICA HJCA RESUMEN INTRODUCCIÓN: La enfermedad de Paget del pezón es infrecuente y representa del 1 al 3 % de las neoplasias de mama. Está asociada con un carcinoma invasivo o in situ en el 82 al 94 % de los casos. Se presenta entre los 55 a 64 años de edad.CASO CLÍNICO: Se presenta el caso de una mujer de 58 años con zona de descamación de 1 cm2 indolora en pezón derecho y tumor de 4 cm2 en mama izquierda, ecografía y mamografía BI-RADS III. Biopsia incisional de pezón derecho que reportó enfermedad de Paget, con ampliación de márgenes. Se completó estudios de extensión con resonancia magnética que reportó lesión retro-areolar sospechosa en mama derecha y lesión nodular maligna en mama izquierda.EVOLUCIÓN: Se realizó cuadrantectomía central más neo-pezón en mama derecha, y en mama izquierda cuadrantectomía superoexterna con vaciamiento ganglionar axilar bilateral, el reporte de patología fue mama derecha negativa para malignidad, mama izquierda hiperplasia intraductal atípica con focos de carcinoma intraductal. Se administró 25 sesiones radioterapia, tras un año de seguimiento se mantiene sin recurrencia.CONCLUSIÓN: La enfermedad de Paget es poco frecuente, pero debe considerarse como diagnóstico diferencial en pacientes sobre los 55 años, su tratamiento estandarizado es quirúrgico, la adyuvancia con radioterapia aún es motivo de discusión. El autoexamen de mama, el acudir a controles periódicos a partir de los 40 años además de realizar una ecografía y mamografía nos lleva a diagnósticos tempranos con un elevado porcentaje de cirugías más conservadoras.

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“…Paget’s disease (PD) is an uncommon cutaneous intraepithelial malignancy characterized histopathologically by large epidermal adenocarcinoma cells (Paget’s cells) containing abundant mucin [ 1 ]. According to the affected anatomic locations, PD is classified as mammary Paget’s disease (MPD) and extramammary Paget’s disease (EMPD).…”

Section: Introductionmentioning

confidence: 99%

“…MPD is characterized by the eczematous eruption and ulceration of the nipple or areola [ 2 ]. The MPD incidence of all breast cancer (BC) is approximately 1%, and more than 90% of Paget’s disease of the nipple is associated with underlying intraductal carcinoma (DCIS) or infiltrating duct carcinoma (IDC) [ 1 , 3 ]. Recent studies have confirmed that MPD conjunction with invasive cancer had worse prognosis [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Establishment and characterization of breast cancer organoids from a patient with mammary Paget’s disease

et al. 2020

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Background Mammary Paget’s disease (MPD) is an uncommon cutaneous intraepithelial malignancy with ulceration of the nipple or areola. Its pathogenesis and genomic mutation remain largely unknown and no cell lines are established from primary tumors. Methods We collected surgical tumor specimens from a 65-year-old Chinese woman diagnosed with MPD and established patient-derived breast cancer (BC) organoids from MPD using organoid culture technology. Results We successfully propagated BC organoids from a patient with MPD for more than 6 months. The organoids were cultured for long-term expansion without any change in spherical organoid morphology. Besides, the spherical organoid morphology did not change when they underwent cryopreservation after resuscitation. The H&E staining and immunohistochemistry analyses showed the similar morphological and histological features of the organoids compared with their paired original BC tissues. The organoids retained positive expression of breast cancer biomarkers: estrogen receptor, progesterone receptor, antigen Ki-67 and negative expression of human epidermal growth factor receptor 2. We also showed that MPD organoids recapitulated the unique genomic landscape including copy number alterations, mutational load, mutational signatures and cancer gene mutations by whole genome sequencing. In situ senescence-associated acid beta galactosidase assay confirmed senescence phenomenon existed in the process of organoids culture and there was no significant difference in the proportion of senescent organoids after organoid passage and resuscitation. Conclusions Our results suggested that an effective platform for ex vivo BC organoids from MPD patients could be used to explore clinicopathological and genomic characteristics of these patients.

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Practical consensus recommendatons for Paget’s disease in breast cancer

Cited by 16 publications

References 35 publications

Invasive Mammary Paget Disease with no Underlying Breast Carcinoma

Invasive Mammary Paget Disease with no Underlying Breast Carcinoma

Caso Clínico: Enfermedad de Paget del Pezón

Establishment and characterization of breast cancer organoids from a patient with mammary Paget’s disease

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