Practical consensus recommendatons for Paget’s disease in breast cancer

A. Gaurav; V. Gupta; R. Koul; S. Dabas; R. Sareen; K. Geeta; V. Arora; Purvish M. Parikh; S. Aggarwal

doi:10.4103/sajc.sajc_107_18

View/Download PDF

Buy Reprints

PDF

Translate this page into:

Original Article

07 (

); 083-086

doi:

10.4103/sajc.sajc_107_18

Practical consensus recommendatons for Paget’s disease in breast cancer

A. Gaurav¹, V. Gupta², R. Koul³, S. Dabas⁴, R. Sareen⁵, K. Geeta⁶, V. Arora⁷, Purvish M. Parikh⁸, S. Aggarwal^9,

1 Department of Endocrinology and Surgery, SGPGI, Lucknow, Uttar Pradesh

2 Department of Surgical Oncology, BLK Super Specialty Hospital, New Delhi

3 Department of Surgical Oncology, Sir Ganga Ram Hospital, New Delhi

4 Department of Surgical Oncology, Fortis Memorial Research Institute, Gurugram, Haryana

5 Department of Surgical Oncology, Indraprastha Apollo Hospital, New Delhi

6 Department of Surgical Oncology, Max Hospital, New Delhi

7 Department of Surgery, Sir Ganga Ram Hospital, New Delhi

8 Department of Oncology, Shalby Cancer and Research Institute, Mumbai, Maharashtra

9 Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi

*Corresponding author: Dr. Shyam Aggarwal. drshyam_aggarwal@yahoo.com

Published: 2020-12-22

MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Licence

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

Disclaimer:
This article was originally published by Thieme Medical and Scientific Publishers Pvt. Ltd. and was migrated to Scientific Scholar after the change of Publisher.

Abstract

Paget's disease of the breast is a rare type of cancer of the nipple–areola complex and that is often associated with an underlying in situ or invasive carcinoma. Diagnosis and treatment of Paget's disease is controversial. Expert oncologists discuss on the update on the approaches of Paget's disease diagnosis and its treatment options. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at this practical consensus recommendations for the benefit of community oncologists.

Keywords

References

Ashikari R, Park K, Huvos AG, Urban JA. Paget's disease of the breast. Cancer 1970;26:680-5.
Desai DC, Brennan EJ Jr., Carp NZ. Paget's disease of the male breast. Am Surg 1996;62:1068-72.
Velpeau A, editor. On Disease of the Mammary Areola Preceding Cancer of the Mammary Region. London: Sydenham Society; 1856.
Paget J. On disease of the mammary areola preceding cancer of the mammary gland. St Barts Hospital Rep 1874;10:87-9.
Dominici LS, Lester S, Liao GS, Guo L, Specht M, Smith BL, et al. Current surgical approach to Paget's disease. Am J Surg 2012;204:18-22.
Chaudary MA, Millis RR, Lane EB, Miller NA. Paget's disease of the nipple: A ten year review including clinical, pathological, and immunohistochemical findings. Breast Cancer Res Treat 1986;8:139-46.
Caliskan M, Gatti G, Sosnovskikh I, Rotmensz N, Botteri E, Musmeci S, et al. Paget's disease of the breast: The experience of the European institute of oncology and review of the literature. Breast Cancer Res Treat 2008;112:513-21.
8. Yim JH, Wick MR, Philpott GW, Norton JA, Doherty GM. Underlying pathology in mammary Paget's disease. Ann Surg Oncol 1997;4:287-92.
Kanitakis J. Mammary and extramammary Paget's disease. J Eur Acad Dermatol Venereol 2007;21:581-90.
Lloyd J, Flanagan AM. Mammary and extramammary Paget's disease. J Clin Pathol 2000;53:742-9.
Dalberg K, Hellborg H, Wärnberg F. Paget's disease of the nipple in a population based cohort. Breast Cancer Res Treat 2008;111:313-9.
Karakas C. Paget's disease of the breast. J Carcinog 2011;10:31.
National Cancer Registry Programme. Indian Council of Medical Research. Leading sites of cancer. In: Consolidated Report of Population Based Cancer Registries 20012004, Incidence and Distribution of Cancer. Bangalore: Coordinating Unit, National Cancer Registry Programme (ICMR); 2006. p. 8-30.
Badwe RA, Gangawal S, Mittra I, Desai PB. Clinico-pathological features and prognosis of breast cancer in different religious communities in India. Indian J Cancer 1990;27:220-8.
Altekruse SF, Kosary CL, Krapcho M. editors. SEER Cancer Statistics Review. National Cancer Institute; 19752007.
National Cancer Registry Program. Ten Year Consolidated Report of the Hospital Based Cancer Registries, 1984–1993, An Assessment of the Burden and Care of Cancer Patients. New Delhi: Indian Council of Medical Research; 2001.
Agarwal G, Pradeep PV, Aggarwal V, Yip CH, Cheung PS. Spectrum of breast cancer in Asian women. World J Surg 2007;31:1031-40.
Sakorafas GH, Blanchard K, Sarr MG, Farley DR. Paget's disease of the breast. Cancer Treat Rev 2001;27:9-18.
Rosen PP. Paget's disease of the nipple. Rosen's Breast Pathology. 2nd ed. Philadelphia: Lippincott-Raven; 2001. p. 565-80.
Franceschini G, Masetti R, D'Ugo D, Palumbo F, D'Alba P, Mulè A, et al. Synchronous bilateral Paget's disease of the nipple associated with bilateral breast carcinoma. Breast J 2005;11:355-6.
21. Kao GF, Graham JH, Helwig EB. Paget's disease of the ectopic breast with an underlying intraductal carcinoma: Report of a case. J Cutan Pathol 1986;13:59-66.
Martin VG, Pellettiere EV, Gress D, Miller AW. Paget's disease in an adolescent arising in a supernumerary nipple. J Cutan Pathol 1994;21:283-6.
Stotter AT, McNeese M, Oswald MJ, Ames FC, Romsdahl MM. The role of limited surgery with irradiation in primary treatment of ductal in situ breast cancer. Int J Radiat Oncol Biol Phys 1990;18:283-7.
Ikeda DM, Helvie MA, Frank TS, Chapel KL, Andersson IT. Paget disease of the nipple: Radiologic-pathologic correlation. Radiology 1993;189:89-94.
Günhan-Bilgen I, Oktay A. Paget's disease of the breast: Clinical, mammographic, sonographic and pathologic findings in 52 cases. Eur J Radiol 2006;60:256-63.
Morrogh M, Morris EA, Liberman L, Borgen PI, King TA. The predictive value of ductography and magnetic resonance imaging in the management of nipple discharge. Ann Surg Oncol 2007;14:3369-77.
Amano G, Yajima M, Moroboshi Y, Kuriya Y, Ohuchi N. MRI accurately depicts underlying DCIS in a patient with Paget's disease of the breast without palpable mass and mammography findings. Jpn J Clin Oncol 2005;35:149-53.
Frei KA, Bonel HM, Pelte MF, Hylton NM, Kinkel K. Paget disease of the breast: Findings at magnetic resonance imaging and histopathologic correlation. Invest Radiol 2005;40:363-7.
Muir R. The pathogenesis of Paget's disease of the nipple and associated lesions. Br J Surg 1935;22:728-37.
Inglis K. Paget's disease of the nipple: With special reference to the changes in the ducts. Am J Pathol 1946;22:1-33.
31. Paone JF, Baker RR. Pathogenesis and treatment of Paget's disease of the breast. Cancer 1981;48:825-9.
Kollmorgen DR, Varanasi JS, Edge SB, Carson WE 3rd. Paget's disease of the breast: A 33-year experience. J Am Coll Surg 1998;187:171-7.
Dixon AR, Galea MH, Ellis IO, Elston CW, Blamey RW. Paget's disease of the nipple. Br J Surg 1991;78:722-3.
Polgár C, Orosz Z, Kovács T, Fodor J. Breast-conserving therapy for Paget disease of the nipple: A prospective European Organization for Research and Treatment of Cancer Study of 61 patients. Cancer 2002;94:1904-5.
Kawase K, Dimaio DJ, Tucker SL, Buchholz TA, Ross MI, Feig BW, et al. Paget's disease of the breast: There is a role for breast-conserving therapy. Ann Surg Oncol 2005;12:391-7.
Bijker N, Rutgers EJ, Duchateau L, Peterse JL, Julien JP, Cataliotti L, et al. Breast-conserving therapy for Paget disease of the nipple: A prospective European Organization for Research and Treatment of Cancer Study of 61 patients. Cancer 2001;91:472-7.
Bulens P, Vanuytsel L, Rijnders A, van der Schueren E. Breast conserving treatment of Paget's disease. Radiother Oncol 1990;17:305-9.
Stockdale AD, Brierley JD, White WF, Folkes A, Rostom AY. Radiotherapy for Paget's disease of the nipple: A conservative alternative. Lancet 1989;2:664-6.
van Dongen JA, Voogd AC, Fentiman IS, Legrand C, Sylvester RJ, Tong D, et al. Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy: European Organization for Research and Treatment of Cancer 10801 trial. J Natl Cancer Inst 2000;92:1143-50.
Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med 2002;347:1227-32.
Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 2002;347:1233-41.
el-Sharkawi A, Waters JS. The place for conservative treatment in the management of Paget's disease of the nipple. Eur J Surg Oncol 1992;18:301-3.
Fourquet A, Campana F, Vielh P, Schlienger P, Jullien D, Vilcoq JR, et al. Paget's disease of the nipple without detectable breast tumor: Conservative management with radiation therapy. Int J Radiat Oncol Biol Phys 1987;13:1463-5.
Stotter AT, McNeese M, Oswald MJ, Ames FC, Romsdahl MM. The role of limited surgery with irradiation in primary treatment of ductal in situ breast cancer. Int J Radiat Oncol Biol Phys 1990;18:283-7.

Fulltext Views
29

PDF downloads
8

View/Download PDF
Download Citations

BibTeX
RIS

Show Sections

[1] Ashikari R, Park K, Huvos AG, Urban JA. Paget's disease of the breast. Cancer 1970;26:680-5.

[2] Desai DC, Brennan EJ Jr., Carp NZ. Paget's disease of the male breast. Am Surg 1996;62:1068-72.

[3] Velpeau A, editor. On Disease of the Mammary Areola Preceding Cancer of the Mammary Region. London: Sydenham Society; 1856.

[4] Paget J. On disease of the mammary areola preceding cancer of the mammary gland. St Barts Hospital Rep 1874;10:87-9.

[5] Dominici LS, Lester S, Liao GS, Guo L, Specht M, Smith BL, et al. Current surgical approach to Paget's disease. Am J Surg 2012;204:18-22.

[6] Chaudary MA, Millis RR, Lane EB, Miller NA. Paget's disease of the nipple: A ten year review including clinical, pathological, and immunohistochemical findings. Breast Cancer Res Treat 1986;8:139-46.

[7] Caliskan M, Gatti G, Sosnovskikh I, Rotmensz N, Botteri E, Musmeci S, et al. Paget's disease of the breast: The experience of the European institute of oncology and review of the literature. Breast Cancer Res Treat 2008;112:513-21.

[8] 8. Yim JH, Wick MR, Philpott GW, Norton JA, Doherty GM. Underlying pathology in mammary Paget's disease. Ann Surg Oncol 1997;4:287-92.

[9] Kanitakis J. Mammary and extramammary Paget's disease. J Eur Acad Dermatol Venereol 2007;21:581-90.

[10] Lloyd J, Flanagan AM. Mammary and extramammary Paget's disease. J Clin Pathol 2000;53:742-9.

[11] Dalberg K, Hellborg H, Wärnberg F. Paget's disease of the nipple in a population based cohort. Breast Cancer Res Treat 2008;111:313-9.

[12] Karakas C. Paget's disease of the breast. J Carcinog 2011;10:31.

[13] National Cancer Registry Programme. Indian Council of Medical Research. Leading sites of cancer. In: Consolidated Report of Population Based Cancer Registries 20012004, Incidence and Distribution of Cancer. Bangalore: Coordinating Unit, National Cancer Registry Programme (ICMR); 2006. p. 8-30.

[14] Badwe RA, Gangawal S, Mittra I, Desai PB. Clinico-pathological features and prognosis of breast cancer in different religious communities in India. Indian J Cancer 1990;27:220-8.

[15] Altekruse SF, Kosary CL, Krapcho M. editors. SEER Cancer Statistics Review. National Cancer Institute; 19752007.

[16] National Cancer Registry Program. Ten Year Consolidated Report of the Hospital Based Cancer Registries, 1984–1993, An Assessment of the Burden and Care of Cancer Patients. New Delhi: Indian Council of Medical Research; 2001.

[17] Agarwal G, Pradeep PV, Aggarwal V, Yip CH, Cheung PS. Spectrum of breast cancer in Asian women. World J Surg 2007;31:1031-40.

[18] Sakorafas GH, Blanchard K, Sarr MG, Farley DR. Paget's disease of the breast. Cancer Treat Rev 2001;27:9-18.

[19] Rosen PP. Paget's disease of the nipple. Rosen's Breast Pathology. 2nd ed. Philadelphia: Lippincott-Raven; 2001. p. 565-80.

[20] Franceschini G, Masetti R, D'Ugo D, Palumbo F, D'Alba P, Mulè A, et al. Synchronous bilateral Paget's disease of the nipple associated with bilateral breast carcinoma. Breast J 2005;11:355-6.

[21] 21. Kao GF, Graham JH, Helwig EB. Paget's disease of the ectopic breast with an underlying intraductal carcinoma: Report of a case. J Cutan Pathol 1986;13:59-66.

[22] Martin VG, Pellettiere EV, Gress D, Miller AW. Paget's disease in an adolescent arising in a supernumerary nipple. J Cutan Pathol 1994;21:283-6.

[23] Stotter AT, McNeese M, Oswald MJ, Ames FC, Romsdahl MM. The role of limited surgery with irradiation in primary treatment of ductal in situ breast cancer. Int J Radiat Oncol Biol Phys 1990;18:283-7.

[24] Ikeda DM, Helvie MA, Frank TS, Chapel KL, Andersson IT. Paget disease of the nipple: Radiologic-pathologic correlation. Radiology 1993;189:89-94.

[25] Günhan-Bilgen I, Oktay A. Paget's disease of the breast: Clinical, mammographic, sonographic and pathologic findings in 52 cases. Eur J Radiol 2006;60:256-63.

[26] Morrogh M, Morris EA, Liberman L, Borgen PI, King TA. The predictive value of ductography and magnetic resonance imaging in the management of nipple discharge. Ann Surg Oncol 2007;14:3369-77.

[27] Amano G, Yajima M, Moroboshi Y, Kuriya Y, Ohuchi N. MRI accurately depicts underlying DCIS in a patient with Paget's disease of the breast without palpable mass and mammography findings. Jpn J Clin Oncol 2005;35:149-53.

[28] Frei KA, Bonel HM, Pelte MF, Hylton NM, Kinkel K. Paget disease of the breast: Findings at magnetic resonance imaging and histopathologic correlation. Invest Radiol 2005;40:363-7.

[29] Muir R. The pathogenesis of Paget's disease of the nipple and associated lesions. Br J Surg 1935;22:728-37.

[30] Inglis K. Paget's disease of the nipple: With special reference to the changes in the ducts. Am J Pathol 1946;22:1-33.

[31] 31. Paone JF, Baker RR. Pathogenesis and treatment of Paget's disease of the breast. Cancer 1981;48:825-9.

[32] Kollmorgen DR, Varanasi JS, Edge SB, Carson WE 3rd. Paget's disease of the breast: A 33-year experience. J Am Coll Surg 1998;187:171-7.

[33] Dixon AR, Galea MH, Ellis IO, Elston CW, Blamey RW. Paget's disease of the nipple. Br J Surg 1991;78:722-3.

[34] Polgár C, Orosz Z, Kovács T, Fodor J. Breast-conserving therapy for Paget disease of the nipple: A prospective European Organization for Research and Treatment of Cancer Study of 61 patients. Cancer 2002;94:1904-5.

[35] Kawase K, Dimaio DJ, Tucker SL, Buchholz TA, Ross MI, Feig BW, et al. Paget's disease of the breast: There is a role for breast-conserving therapy. Ann Surg Oncol 2005;12:391-7.

[36] Bijker N, Rutgers EJ, Duchateau L, Peterse JL, Julien JP, Cataliotti L, et al. Breast-conserving therapy for Paget disease of the nipple: A prospective European Organization for Research and Treatment of Cancer Study of 61 patients. Cancer 2001;91:472-7.

[37] Bulens P, Vanuytsel L, Rijnders A, van der Schueren E. Breast conserving treatment of Paget's disease. Radiother Oncol 1990;17:305-9.

[38] Stockdale AD, Brierley JD, White WF, Folkes A, Rostom AY. Radiotherapy for Paget's disease of the nipple: A conservative alternative. Lancet 1989;2:664-6.

[39] van Dongen JA, Voogd AC, Fentiman IS, Legrand C, Sylvester RJ, Tong D, et al. Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy: European Organization for Research and Treatment of Cancer 10801 trial. J Natl Cancer Inst 2000;92:1143-50.

[40] Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med 2002;347:1227-32.

[41] Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 2002;347:1233-41.

[42] el-Sharkawi A, Waters JS. The place for conservative treatment in the management of Paget's disease of the nipple. Eur J Surg Oncol 1992;18:301-3.

[43] Fourquet A, Campana F, Vielh P, Schlienger P, Jullien D, Vilcoq JR, et al. Paget's disease of the nipple without detectable breast tumor: Conservative management with radiation therapy. Int J Radiat Oncol Biol Phys 1987;13:1463-5.

[44] Stotter AT, McNeese M, Oswald MJ, Ames FC, Romsdahl MM. The role of limited surgery with irradiation in primary treatment of ductal in situ breast cancer. Int J Radiat Oncol Biol Phys 1990;18:283-7.

Practical consensus recommendatons for Paget’s disease in breast cancer

Abstract

Abstract

Keywords

References

Suggested read for related articles:

We value your privacy