Cancer Treatment Reviews
Volume 27, Issue 1 , Pages 9-18 , February 2001

Paget’s disease of the breast

  • G.H. Sakorafas

      Affiliations

    • Department of Surgery, 251 Hellenic Air Force (HAF) General Hospital, GR – 115 25, Athens, Greece
  • ,
  • K. Blanchard

      Affiliations

    • Department of Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesoto, USA
  • ,
  • M.G. Sarr

      Affiliations

    • Department of Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesoto, USA
  • ,
  • D.R. Farley

      Affiliations

    • Department of Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesoto, USA

References 

    REFERENCES
  1. Velpeau, S. Treatise on Diseases of the Breast and Mammary Region, London, Sydenham Society, 1856
  2. Paget J. On the disease of the mammary areola preceding cancer of the mammary gland. St Bartholomew Hosp Rep. 1874;10:87–89
  3. Crocker HR. Paget’s disease affecting the scrotum and penis. Trans Pathol Soc Lond. 1889;40:187–191
  4. Thin G. On the connection between disease of the nipple and areola and tumors of the breast. Trans Pathol Soc Lond. 1881;32:218–222
  5. Cheatle GL, Cutler M. Paget’s disease of the nipple. Arch Pathol. 1931;12:435–466
  6. Muir R. The pathogenesis of Paget’s disease of the nipple and associated lesions. Br J Surg. 1935;22:728–737
  7. Muir R. Further observations on Paget’s disease of the nipple and associated lesions. J Pathol. 1939;49:299–312
  8. Inglis K. Paget’s disease of the nipple with special references to changes of the ducts. Am J Pathol. 1946;22:1–33
  9. Ascensao AC, Marques MSJ, Capitao-Mor M. Paget’s disease of the nipple: Clinical and pathological review of 109 female patients. Dermatologica. 1985;170:170–175
  10. Ashikari R, Park K, Huvos AG. Paget’s disease of the nipple. Cancer. 1970;26:680–685
  11. Chaudary MA, Millis RR, Lane B. Paget’s disease of the nipple: a 10-year review including clinical, pathological and immunohistochemical findings. Breast Cancer Res Treat. 1986;8:139–146
  12. Nance FC, DeLoach DH, Welsh RA. Paget’s disease of the breast. Ann Surg. 1970;171:864–874
  13. Inwang ER, Fentiman IS. Paget’s disease of the nipple. Br J Hosp Med. 1990;44:392–395
  14. Jamali FR, Ricci A, Deckers PJ. Paget’s disease of the breast. Am J Surg. 1970;76:365–381
  15. Kister A, Haagensen C. Paget’s disease of the breast. Am J Surg. 1970;119:606–609
  16. Paone J, Baker R. Pathogenesis and treatment of Paget’s disease of the breast. Cancer. 1981;48:825–829
  17. Menzies D, Barr L, Ellis H. Paget’s disease of the nipple occurring after wide local excision and radiotherapy for carcinoma of the breast. Eur Surg Oncol. 1989;15:271–273
  18. Sakorafas GH. Breast Cancer. Lagos D Medical Publications; 1999;
  19. Fernandes FJ, Costa MM, Bernardo M. Rarities in breast pathology. Bilateral Paget’s disease of the breast—a case report. Eur J Surg Oncol. 1990;16:172–174
  20. Martin VG, Pellettiere EV, Gress D, Miller AW. Paget’s disease in an adolescent arising in a supernumerary nipple. J Cutan Pathol. 1994;21:283–286
  21. Ward KA, Burton JL. Dermatological diseases of the breast in young women. Clin Dermatol. 1997;15:45–52
  22. Osther PJ, Balslev E, Blichert-Toft M. Paget’s disease of the nipple. Acta Chir Scand. 1990;156:343–352
  23. Maier WR, Rosemong GP, Harasym EL. Paget’s disease of the female breast. Surg Gynecol Obstet. 1969;128:1253–1263
  24. 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;18:301–303
  25. Dixon JM, Sainsbury JRC, Rodger A. Breast cancer: treatment of elderly patients and uncommon conditions. Br Med J. 1994;309:1292–1295
  26. Eusebio RB, Deckers PJ. Paget’s disease of the nipple-areola complex: a plea for conservatism. Contemp Surg. 1992;40:13–16
  27. Jones RE. Mammary Paget’s disease without underlying carcinoma. Am J Dermatopathol. 1985;7:361–365
  28. Masters RK, Robertson JFR, Blamey RW. Healed Paget’s disease of the nipple. Lancet. 1993;341:253
  29. Serour F, Birkenfeld S, Amsterdam E. Paget’s disease of the male breast. Cancer. 1988;62:601–605
  30. Gupta S, Khanna NN, Khanna S. Paget’s disease of the male breast: a clinicopathologic study and a collective review. J Surg Oncol. 1983;22:151–156
  31. Lancer HA, Moschella SL. Paget’s disease of the male breast. J Am Acad Dermatol. 1982;7:393–396
  32. O’Sullivan ST, McGreal GT, Lyons A. Paget’s disease of the breast in a man without underlying breast carcinoma. J Clin Pathol. 1994;47:851–852
  33. Nhung TC, Jacques M, Schopflocher P. Pigmented Paget’s disease of the male breast. J Am Acad Dermatol. 1990;23:338–341
  34. Holloway KB, Ramos-Caro FA, Flowers FP. Paget’s disease of the breast in a man with neurofibromatosis. Int J Dermatol. 1997;36:604–618
  35. Sawyer RH, Asbury DL. Mammographic appearances in Paget’s Disease of the Breast. Clin Radiol. 1994;49:185–188
  36. Ceccherini AFA, Evans AJ, Pinder SE. Is ipsilateral mammography worthwhile in Paget’s disease of the breast?. Clin Radiol. 1996;51:35–38
  37. Rickard MT, Selopranoto US. Paget’s disease of the breast: what the radiologist may expect to find. Australasia Radiol. 1995;39:27–30
  38. Ikeda DM, Helvie MA, Frank TS. Paget disease of the nipple: radiologic-pathologic correlation. Radiology. 1993;189:89–94
  39. Burke ET, Brauning MP, McLelland R. Paget disease of the breast: a pictorial assay. Radiographics. 1998;18:1459–1464
  40. Malek G, Tapolcsanyi L. Characteristics of Paget’s carcinoma of the nipple and problems of its negligence. Oncology. 1974;30:278–293
  41. Kamio T, Kameoka S, Kimura T. Ultrasonographic diagnosis of intraductal spreading of breast cancer – study on non-palpable breast cancer. Jpn J Breast Cancer. 1991;6:455–464
  42. Tohno E, Cosgrove DO, Sloane JP. Ultrasound Diagnosis of Breast Disease. London: Churchill Livingstone; 1994; p. 76–178
  43. Yang WT, King W, Metreweli C. Clinically and mammographically occult invasive ductal carcinoma diagnosed by ultrasound: the focally dilated duct. Australas Radiol. 1997;41:73–75
  44. Friedman EP, Hall-Craggs MA, Mumtaz H, Schneidau A. Breast MR and the appearance of normal and abnormal nipple. Clin Radiol. 1997;52:854–861
  45. Tilanus-Linthorst MMA, Obdeijn AIM, Oudkerk M. MRI in patients with axillary metastases of occult breast carcinoma. Breast Cancer Res Treat. 1997;44:179–182
  46. Mezi S, Scopinaro F, Marzullo A. 99mTc MIBI prone scintimammography in breast Paget’s disease: a case report. Oncol Rep. 1999;6:45–48
  47. Yim JH, Wick MR, Philpott GW. Underlying pathology in mammary Paget’s disease. Ann Surg Oncol. 1997;4:287–292
  48. Hitchcock A, Topham S, Bell J. Routine diagnosis of mammary Paget’s disease. A modern approach. Am J Surg Pathol. 1992;16:58–61
  49. Nakamura G, Shikata N, Shoji T. Immunohistochemical study of mammary and extramammary Paget’s disease. Anticancer Res. 1995;15:467–470
  50. Wolber RA, Dupuis BA, Wick MR. Expression of c-erbB-2 oncoprotein in mammary and extrammamary Paget’s disease. Am J Clin Pathol. 1991;96:243–247
  51. Keating L, Sinclair J, Wright C. C-erbB-2 oncoprotein expression in mammary and extrammamary Paget’s disease: an immunohistochemical study. Histopathology. 1990;17:243–247
  52. De Potter CR. The neu-oncogene: more than a prognostic indicator?. Hum Pathol. 1994;25:1264–1266
  53. Lagios MD, Margolin FR, Westdahl PR, Rose MR. Mammographically detected duct carcinoma in situ: frequency of local recurrence following tylectomy and prognostic effect of nuclear grade on local recurrence. Cancer. 1989;63:618–624
  54. Patchefsky AS, Schwartz GF, Finkelstein SD. Heterogeneity of intraductal carcinoma of the breast. Cancer. 1989;63:731–741
  55. Silverstein MJ, Waisman JR, Gamagami P. Intraductal carcinoma of the breast (208 cases): clinical factors influencing treatment choice. Cancer. 1990;66:102–108
  56. Fisher ER, Constantino J, Fisher B. Pathologic findings from the National Surgical Adjuvant Breast Project (NSABP) protocol B-17. Cancer. 1995;75:1310–1315
  57. Lagios MD, Westdahl PR, Rose MR, Concannon S. Paget’s disease of the nipple. Alternative management in cases without or with minimal extent of underlying breast carcinoma. Cancer. 1984;54:545–551
  58. Sagami S. Electron microscopic studies in Paget’s disease. Med J Osaka Univ. 1963;14:173–188
  59. Sagebiel RW. Ultrastructural observations on epidermal cells in Paget’s disease of the breast. Am J Pathol. 1969;57:49–64
  60. Cohen C, Guarner J, DeRose PB. Mammary Paget’s disease and associated carcinoma. An immunohistochemical study. Arch Pathol Lab Med. 1993;117:291–294
  61. Kariniemi AL, Forsman L, Wahistrom T. Expression of differentiation antigens in mammary and extramammary Paget’s disease. Br J Dermatol. 1984;;110:203–210
  62. Schelfhout VR, Coene ED, Delaey B. Pathogenesis of Paget’s disease: epidermal heregulin-alpha, motility factor, and the HER receptor family. J Natl Cancer Inst. 2000;92:622–628
  63. Jahn H, Osther PJ, Nielsen EH. An electron microscopic study of clinical Paget’s disease of the nipple. APMIS. 1995;103:628–634
  64. Lucarotti ME, Dumm JM, Webb AJ. Scrape cytology in the diagnosis of Paget’s disease of the breast. Cytopathology. 1994;5:301–305
  65. Samarasinghe D, Frost F, Sterrett G. Cytological diagnosis of Paget’s disease of the nipple by scrape smears: a report of five cases. Diagn Cytopathol. 1993;9:2915
  66. Schmitt SJ, Connolly J, Khettry U. Pathologic findings on re-excision of the primary site in breast cancer patients considered for treatment by primary radiation therapy. Cancer. 1987;79:675–681
  67. Dixon AR, Gales MH, Ellis IO. Paget’s disease of the nipple. Br J Surg. 1991;78:722–723
  68. Vianna LL, Millis RR, Fentinan IS. Adenoma of the nipple: a diagnostic dilemma. Br J Hosp Med. 1993;50:639–642
  69. Haier J, Haensch W, Schon M. Leiomyoma as a rare differential diagnosis of Paget’s disease of the nipple. Acta Obstret Gynecol Scand. 1997;76:490–491
  70. Van der Putte SC, Toonstra J, Hennipman A. Mammary Paget’s disease confined to the areola and associated with multifocal Toker cell hyperplasia. Am J Dermatopathol. 1995;17:487–493
  71. Miller L, Tyler W, Maroon M, Miller OFIII. Erosive adenomatosis of the nipple: a benign imitator of malignant breast disease. Cutis. 1997;59:91–92
  72. Lundquist K, Kohler S, Rouse RV. Intraepidermal cytokeratin 7 expression is not restricted to Paget cells but is also seen in Toker cells and Merkel cells. Am J Surg Pathol. 1999;23:212–219
  73. Viehl P, Validire O, Kheirallah S. Paget’s disease of the nipple without clinically and radiologically detectable breast tumor: histochemical and immunohistochemical study of 44 cases. Pathol Res Pract. 1993;189:150–155
  74. Deasai DC, Brennan EJ, Carp NZ. Paget’s disease of the male breast. Am Surg. 1996;62:1068–1072
  75. Schwartz GF, Patchefsy AS, Finklestein SD. Non-palpable in-situ ductal carcinoma of the breast. Arch Surg. 1989;124:29–32
  76. Fentiman IS, Fagg N, Millis RR, Hayward JL. In-situ ductal carcinoma of the breast: implications of disease pattern and treatment. Eur J Surg Oncol. 1986;12:261–266
  77. Locker AP, Horrocks C, Gilmore AS. Flow cytometric and histological analysis of ductal carcinoma in situ of the breast. Br J Surg. 1990;77:564–567
  78. Borg A, Linell F, Idvall I. HER2/neu amplification and comedo type breast carcinoma. Lancet. 1989;1:1268–1269
  79. Slamon DJ, Goldolphin W, Jones LA. Studies of HER-2/neu protooncogene in human breast and ovarian cancer. Science. 1989;58:543–548
  80. Rissanen P, Holsti P. Paget’s disease of the breast: the influence of the presence or absence of an underlying palpable tumor on the prognosis and the choice of treatment. Oncology. 1969;;23:209–216
  81. Freund H, Maydovnik M, Laufer N, Durst A. Paget’s disease of the breast. J Surg Oncol. 1977;9:93–98
  82. Kay S. Paget’s disease of the nipple. Surg Gynecol Obstet. 1966;23:1010–1014
  83. Kollmorgen DR, Varanasi JS, Edge SB. Paget’s disease of the Breast: A 33-year experience. J Am Coll Surg. 1998;187:171–177
  84. Fourquet A, Campana F, Vielh P. Paget’s disease of the nipple without detectable breast tumor: conservative management with radiation therapy. Int J Radiat Oncol Biol Phys. 1987;13:1463–1465
  85. Pierce L, Haffty B, Solin L. The conservative management of Paget’s disease of the breast with radiotherapy. Cancer. 1997;80:1065–1072
  86. Bulens P, Vanuytsel L, Rijnders A, van der Schueren E. Breast conserving treatment of Paget’s disease. Radiother Oncol. 1990;17:305–309
  87. Stockdale A, Brierley J, White W. Radiotherapy for Paget’s disease of the nipple: conservative alternative. Lancet. 1989;ii:664–666
  88. Anelli A, Anelli TF, McCormick B. Conservative management of Paget’s disease of the nipple [meeting abstract]. Proc Annu Meet Am Soc Clin Oncol. 1995;A100
  89. Stotter AT, McNeese M, Oswald MJ. The role of limited surgery with irradiation in primary treatment of ductal in-situ breast cancer. Int J Radiat Oncol Biol Phys. 1990;18:283–287
  90. Solin LJ, Fowble B, Martz K. Results of re-excisional biopsy of the primary tumor in preparation for definitive irradiation of patients with early stage breast cancer. Int J Radiat Oncol Biol Phys. 1986;12:721–725
  91. Moore MM. Treatment of ductal carcinoma in situ of the breast. Semin Surg Oncol. 1991;7:267–275
  92. Vezeridis MP, Bland KI. Management of ductal carcinoma in situ. Surg Oncol. 1994;3:309–314
  93. Mai KT, Yazdi HM, Burns BF. Pattern of distribution of intraductal and infiltrating ductal carcinoma: a three dimensional study using serial coronal giant sections of the breast. Hum Pathol. 2000;31:464–474
  94. Sakorafas GH, Tsiotou AG. Sentinel lymph node biopsy in breast cancer. Am Surg. 2000;66:667–674

PII: S0305-7372(00)90203-2

doi: 10.1053/ctrv.2000.0203

Cancer Treatment Reviews
Volume 27, Issue 1 , Pages 9-18 , February 2001