Paget's disease of nipple with dermal invasion: A case report

Cancer Rep (Hoboken). 2022 Aug;5(8):e1572. doi: 10.1002/cnr2.1572. Epub 2021 Oct 27.

Abstract

Background: Invasive mammary Paget's disease (MPD) is an extremely rare eczematous eruption on the nipple and areola with an invasion of the dermis by Paget cells. This entity can often be misdiagnosed and overtreated for invasive carcinoma of the breast.

Case: A 34-year woman presented with a 2-year history of right nipple eczema and right axillary lump for a month. Breast ultrasound revealed dilated intra-nipple lactiferous duct and an enlarged right axillary lymph node. Histopathology from biopsy revealed MPD with ductal carcinoma in situ (DCIS) whereas final histopathology after right modified radical mastectomy revealed Invasive MPD with DCIS and axillary metastasis. She underwent adjuvant chemotherapy and is under hormonal therapy with complete remission for 18 months.

Conclusion: Awareness of invasive MPD is important to avoid misdiagnosis and probable radical treatment. Close follow-up is warranted due to limited knowledge regarding treatment and prognosis of invasive MPD.

Keywords: DCIS; breast; invasive Paget's disease; nipple.

Publication types

  • Case Reports

MeSH terms

  • Breast Neoplasms* / diagnosis
  • Breast Neoplasms* / pathology
  • Breast Neoplasms* / therapy
  • Carcinoma, Intraductal, Noninfiltrating* / diagnosis
  • Carcinoma, Intraductal, Noninfiltrating* / pathology
  • Carcinoma, Intraductal, Noninfiltrating* / therapy
  • Female
  • Humans
  • Mastectomy
  • Nipples / pathology
  • Nipples / surgery
  • Paget's Disease, Mammary* / diagnosis
  • Paget's Disease, Mammary* / surgery