Surgical treatment in Paget's disease of the breast

Siponen, E.; Hukkinen, Katja; Heikkilä, Päivi; Joensuu, Heikki; Leidenius, Marjut

doi:10.1016/j.amjsurg.2009.07.044

Cited by 40 publications

(28 citation statements)

References 14 publications

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“…Study sizes ranged from 45 to 212 patients. 1 study [7] investigated the role of MRI in evaluating patients with a diagnosis of PD, and another 2 studies [8,9] reported the use of tamoxifen. The majority of the studies had local recurrence as the primary outcome.…”

Section: Resultsmentioning

confidence: 99%

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Local Breast Cancer Recurrence after Mastectomy and Breast-Conserving Surgery for Paget's Disease: A Meta-Analysis

Huang

Zhou

2014

Breast Care

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Background: Paget's disease (PD) of the breast is a rare presentation of breast malignancy. Mastectomy has been considered the standard of care, but several studies have shown that breast-conserving surgery (BCS) with radiotherapy is an alternative option. According to the literature, the total recurrence rate is as high as 20-40%. In an effort to enable a rational therapy decision, we compiled and analyzed the available data on PD. Methods: Pubmed, Web of Knowledge, and China Journal Net were searched for studies concerning treatment for PD between 1990 and 2013. A meta-analysis was performed to compare the effect of different treatments. Results: 7 studies with a total of 685 patients were included. The cumulative local recurrence rate was 7.6%, 5.6% among women undergoing mastectomy and 13.2% among those treated with BCS. Compared to the BCS group, mastectomy showed significant differences in terms of local recurrence (odds ratio = 0.38, 95% confidence interval 0.21-0.69; p = 0.001). Conclusion: Since not all currently available diagnostic and therapeutic options (magnetic resonance imaging, radiotherapy, tamoxifen) were systematically used in the studies included in this meta-analysis, it may be presumptuous to suggest that mastectomy is the right choice for all patients with PD in a modern interdisciplinary setting. Rather we can conclude that all efforts should be undertaken to assure local control since BCS is not equivalent to mastectomy in the treatment of PD.

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Section: Resultsmentioning

confidence: 99%

“…Since ultrasound and mammography are not specific enough to detect multifocal and/or multicentric disease, MRI may be helpful. According to several studies, MRI was highly sensitive in detecting invasive cancer in patients with PD, even if ultrasound and mammography showed negative results [7,10,11]. …”

Section: Discussionmentioning

confidence: 99%

Local Breast Cancer Recurrence after Mastectomy and Breast-Conserving Surgery for Paget's Disease: A Meta-Analysis

Huang

Zhou

2014

Breast Care

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“…In short, Paget's disease is frequently associated with underlying peripheral or multicentric breast cancer. Therefore, mastectomy with sentinel node biopsy (SNB) is probably the best treatment option for the majority of patients (10).…”

Section: Discussionmentioning

confidence: 99%

Synchronous bilateral Paget’s disease of the breast: A case report

Xie¹,

Zheng²,

Lan³

et al. 2012

Oncology Letters

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Abstract. Synchronous bilateral Paget's disease of the nipple is extremely rare. In the present study, we report a case of synchronous bilateral Paget's disease in a 45-year-old woman who had a medical history of gastric cancer. The patient presented with a 6-month history of eczema and itching in both nipples. Mammography and ultrasonography did not reveal any mass lesions in the bilateral breast, and computed tomography and bone scintigraphy showed no site of distant metastasis. The patient was scheduled for mastectomy and sentinel node biopsy. The histological diagnosis was Paget's disease of the breast with no evidence of underlying invasive ductal carcinoma or ductal carcinoma in situ of the breast tissue. There was no metastasis in either of the sentinel nodes. Immunohistochemical staining showed a negative expression of oestrogen and progesterone receptors. The patient has not received chemotherapy, radiotherapy or hormonal therapy. The patient has been disease-free for 7 months following surgery.

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“…Поражение аксилляр-ных ЛУ значительно ухудшает прогноз. Центральная резекция должна быть обязательно дополнена либо биопсией сигнального ЛУ при клинически негативных случаях, либо полноценной аксиллярной лимфаденэк-томией, если ЛУ клинически позитивные [34,58,59].…”

Section: рис 4 маммография (а б): отсутствие изменений в области сunclassified