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Mammary Paget Disease

Paget Disease of the Nipple


Presentation

  • We have studied the presentation and symptoms of Paget's disease, local control and breast cancer corrected survival following breast conserving surgery or mastectomy.[ncbi.nlm.nih.gov]
  • When present, the prognosis is the poorest. About 31 (62%) of 50 patients with mammary Paget disease present with a detectable breast mass.[web.archive.org]
  • Pigmented mammary Paget disease (PMPD) is a rare disease that may mimic cutaneous melanoma both in clinical presentation and on histology.[ncbi.nlm.nih.gov]
  • The prognosis, or outlook, for people with Paget disease of the breast depends on a variety of factors, including the following: Whether or not a tumor is present in the affected breast If one or more tumors are present in the affected breast, whether[medicinenet.com]
  • We have studied the presentation and symptoms of Paget’s disease, local control and breast cancer corrected survival following breast conserving surgery or mastectomy.[doi.org]
Fishing
  • Eighty percent of the cases showed strong overexpression (3 ) of HER-2 protein by IHC, and all of these cases showed more than 5-fold amplification of the HER-2 gene by FISH.[ncbi.nlm.nih.gov]
Lichenification
  • […] buttocks, thighs, eyelids, and external auditory canals may be affected. 4 Patients with EMPD typically present with well-demarcated, nonresolving, erythematous and eczematous plaques that may have associated crusting, scaling, papillomatous excrescences, lichenification[mdedge.com]
Suggestibility
  • Confocal microscopic features, such as large reflecting cells with dark nuclei spreading upward in pagetoid fashion, were suggestive of melanoma.[ncbi.nlm.nih.gov]
  • Paget cells and underlying ductal carcinoma cells have been shown to be positive for the oncogene HER2/neu, suggesting common genetic alterations for both the epidermal and breast tumor cells.[emedicine.com]
  • Earlier studies have suggested that 100% of the tumor cells in mammary Paget disease show overexpression of HER-2 protein.[ncbi.nlm.nih.gov]
  • The other theory suggests that skin cells of the nipple spontaneously become Paget cells.[web.archive.org]
Anger
  • Prolonged stress may lead to frustration, anger, hopelessness, and -- at times -- depression. The person with the illness is not the only one affected. Family members are also influenced by the health changes of a loved one.[web.archive.org]
  • Your feelings Back to top You may have many different emotions, including anger, resentment, guilt, anxiety and fear. These are all normal reactions, and are part of the process many people go through in trying to come to terms with their illness.[web.archive.org]
Nipple Discharge
  • Paget Disease of the Breast Nipple Discharge Breast discharge is the spontaneous flow of fluid from the nipple at any time other than during nursing.[medicinenet.com]
  • If you have nipple discharge, a sample of the discharge might also be collected for microscopic examination. If cancer cells are detected in the samples collected, you may be referred to a breast surgeon to discuss treatment options.[web.archive.org]
  • Possible signs and symptoms of Paget's disease of the breast include: Flaky or scaly skin on your nipple Crusty, oozing or hardened skin resembling eczema, on the nipple, areola or both Redness Itching A burning sensation Straw-colored or bloody nipple[web.archive.org]
  • During the physical exam the doctor is going to examine the breast for lumps and nipple discharge. In many cases of breast cancer there can be both occurring, and that would give the doctor a better idea of what is going on.[web.archive.org]
  • A sample of nipple discharge may also be examined under a microscope for the presence of Paget cells ( 3 ).[web.archive.org]
Bloody Nipple Discharge
  • Possible signs and symptoms of Paget's disease of the breast include: Flaky or scaly skin on your nipple Crusty, oozing or hardened skin resembling eczema, on the nipple, areola or both Redness Itching A burning sensation Straw-colored or bloody nipple[web.archive.org]
Bleeding from the Nipple
Ulcer of Nipple
  • […] the nipple might flatten out or turn inwards (invert) there may be a discharge or bleeding from the nipple the area might feel itchy or sore there may be a lump in the same breast.[breast-cancer.canceraustralia.gov.au]
Burning Sensation
  • […] within the skin lesion Symptoms of pain, itching, and a burning sensation prompt patients to seek medical attention.[web.archive.org]
  • Clinically, extramammary Paget's disease begins insidiously with pruritis and burning sensation. The macroscopic appearance ranges from flaking, oozing and maceration to crusted plaque and tumour formation.[histopathology-india.net]
  • Possible signs and symptoms of Paget's disease of the breast include: Flaky or scaly skin on your nipple Crusty, oozing or hardened skin resembling eczema, on the nipple, areola or both Redness Itching A burning sensation Straw-colored or bloody nipple[web.archive.org]
  • It occurs more in women and starts usually in the fifth decade or thereafter. [5] The patients present with pruritus, bleeding, oozing, tenderness, painful burning sensation, or hypopigmented/eczematous lesions.[e-ijd.org]
  • Some women have a burning sensation. These symptoms usually occur in more advanced stages, when serious destruction of the skin often prompts the patient to consult. Lumps or masses in the breast occur in 50% of the patients.[en.wikipedia.org]

Workup

  • Proper recognition of this disorder is required to initiate an appropriate workup (eg, skin biopsy) for differentiating it from other benign inflammatory dermatosis and for detecting an underlying breast carcinoma.[web.archive.org]

Treatment

  • These studies are designed to find new treatments and better ways to use current treatments. As new and improved treatments are found for breast cancer, the treatment options for Paget disease of the nipple will also improve ( 2, 5 ).[web.archive.org]
  • Surgery is the usual treatment for Paget's disease of the nipple. Additional treatments may be recommended under certain circumstances. Many clinical trials for breast cancer are underway.[web.archive.org]
  • Keywords Paget’s disease of the nipple Symtoms Treatment Prognosis This is a preview of subscription content, log in to check access. References 1.[doi.org]
  • However, people who have Paget disease of the breast may be eligible to enroll in clinical trials to evaluate new treatments for breast cancer in general, new ways of using existing breast cancer treatments, or strategies for preventing breast cancer[medicinenet.com]
  • What is the treatment? The usual treatment is local surgical excision; however, recurrence is frequent. The excision should be wide enough to get a disease-free margin, usually 1.5 to 2 cm away from the visible lesion.[britishskinfoundation.org.uk]

Prognosis

  • Patients generally have a very good prognosis depending on the extent of the malignancy.[aocd.org]
  • The hallmark is relentless progression despite topical therapy and the sharp-raised margin. [2] Three patterns of EMPD are accepted: (1) In situ epithelial form without carcinoma and excellent prognosis, (2) epithelial form with adnexal carcinoma, and[e-ijd.org]
  • Men tend to present with earlier symptoms, nevertheless, prognosis is known to be worse, with only 20% to 30% of the patients surviving over a five year period.[sciedupress.com]
  • MPD is often associated with extensive underlying malignancy which is of high grade and is frequently Her2 neu positive with a resulting poor prognosis.[scopemed.org]

Etiology

  • […] genitalia and perineal skin may be associated with bladder, urethra, prostate cancer, or colorectal neoplasia. [3] Due to such associations, a complete investigation for an underlying carcinoma should accompany every confirmed diagnosis of EMPD. [4] Etiology[e-ijd.org]
  • The purpose of the work is to make a clinical laboratory evaluation of the role of urogenital opportunistic pathogenic flora in etiology and pathogenesis of pathological uterine cervix conditions and to identify possible preventive measures to uterine[giog.it]

Epidemiology

  • Epidemiology First Online: 19 October 2007 Abstract Background Paget’s disease of the nipple is a rare form of breast cancer characterised by the presence of intraepidermal tumour cells.[doi.org]
  • Epidemiology Paget's disease of the breast, a disorder of the nipple-areola complex, first described by Sir James Paget in 1874, 2 Dermatopathology of the Female Breast Margot S. Peters,Julia S. Lehman,Nneka I.[doi.org]
  • According to NCI's Surveillance, Epidemiology, and End Results program, the 5-year relative survival for all women in the United States who were diagnosed with Paget disease of the breast between 1988 and 2001 was 82.6 percent.[medicinenet.com]
  • According to NCI’s Surveillance, Epidemiology, and End Results program, the 5-year relative survival for all women in the United States who were diagnosed with Paget disease of the breast between 1988 and 2001 was 82.6 percent.[cancer.gov]
Sex distribution
Age distribution

Pathophysiology

  • In triple or quadruple extra-mammary Paget’s disease, the racial and gender differences in incidence, the pathophysiology underlying simultaneous distant occurrence of three or four lesions, and their malignant potentials are the matters to be elucidated[medicaljournals.se]
  • Pathophysiology The pathogenesis of mammary Paget disease and the origin of Paget cells were once controversial.[web.archive.org]
  • […] of female breast cancer. [ 2 ] It is also seen in male breast cancer but extremely rarely. [ 3 ] Most cases of Paget's disease of the breast are associated with invasive breast cancer - although 40% are associated with ductal carcinoma in situ. [ 2 ] Pathophysiology[patient.info]

Prevention

  • Breast Cancer - Get the facts on breast cancer symptoms, signs, stages, types, research, risk factors, diagnosis, prevention information and treatment options: mastectomy, chemotherapy, radiation therapy.[web.archive.org]
  • In most cases, radiation therapy is also used to help prevent recurrence (return of the cancer).[web.archive.org]
  • They usually undergo radiation therapy after the actual procedure to prevent recurrence. A breast-conserving surgery consists in the removal of the nipple, areola and the part of the breast that is affected by cancer.[en.wikipedia.org]
  • KEY WORDS: Empowerment - Behavior - Cervical cancer prevention - Women of childbearing age. Last Issue Toc Last Viewed[giog.it]
  • However, people who have Paget disease of the breast may be eligible to enroll in clinical trials to evaluate new treatments for breast cancer in general, new ways of using existing breast cancer treatments, or strategies for preventing breast cancer[medicinenet.com]

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