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1.
Zhonghua Zhong Liu Za Zhi. 2018 Jul 23;40(7):523-527. doi: 10.3760/cma.j.issn.0253-3766.2018.07.008.

[Clinicopathological characteristics and prognosis analysis with Paget's disease of the breast].

[Article in Chinese; Abstract available in Chinese from the publisher]

Author information

1
Department of Breast Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
2
Department of Breast Surgery, Affiliated Hospital of Chifeng University, Chifeng 024005, China.
3
Pancreatic and Stomach Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

Abstract

Objective: The aim of this study was to explore the clinicopathologic characteristics and prognostic factors of Paget's disease. Methods: 137 patients with Paget's disease of the breast who were diagnosed in Cancer Hospital Chinese Academy of Medical Sciences between January 2007 and May 2016 were identified and included in the study, including 134 females and 3 males. Results: The average age at onset of the disease was 51.8 years(range, 27-78 years). Among the 137 patients, 7 cases were Paget's disease without any other underlying malignancy, who were alive during the follow-up period. The other 130 patients were diagnosed with Paget's disease and underlying ductal carcinoma in situ (DCIS) or (and) with an invasive carcinoma. The positive expression rates of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) were 29.2%(40/137), 38.0%(52/137)and 78.1%(107/137), respectively. The two-year and five-year overall survival were 99.0%, 96.0%, and disease-free survival of two-year and five-year were 97.6%, 92.8%, respectively for all 137 patients. On survival analysis, longer course of disease, HER-2 positivity, tumor stage(T1-T4), and axillary lymph node metastasis were significantly associated with overall survival. Conclusions: Paget's disease of the breast is a slowly progressive malignancy with good prognosis. A longer course of disease, HER-2 positivity, tumor stage, axillary lymph node metastasis and distant metastasis were significantly associated with poor prognosis.

KEYWORDS:

Paget′s disease, Mammary; Pathology, Clinical; Prognosis; Therapy

PMID:
30060361
[Indexed for MEDLINE]
Icon for Chinese Medical Association Publishing House Ltd.
2.
PLoS One. 2018 May 16;13(5):e0197156. doi: 10.1371/journal.pone.0197156. eCollection 2018.

Sonographic visualization of nipple blood flow can help differentiate Paget disease from benign eczematous nipple lesions.

Author information

1
Division of Breast and Endocrine Surgery (Omori), Department of Surgery, School of Medicine, Toho University, Omorinishi, Ota-ku, Tokyo, Japan.
2
Department of Clinical Physiology, Toho University Medical Center Omori Hospital, Omorinishi, Ota-ku, Tokyo, Japan.
3
Department of Pathology, School of Medicine, Toho University, Omorinishi, Ota-ku, Tokyo, Japan.
4
Department of Radiology, School of Medicine, Toho University, Omorinishi, Ota-ku, Tokyo, Japan.
5
Department of Surgical Pathology, School of Medicine, Toho University, Omorinishi, Ota-ku, Tokyo, Japan.

Abstract

PURPOSE:

Paget disease of the breast is a rare cancer that originates from the nipple-areolar complex. It is often overlooked and misdiagnosed as benign chronic eczema of the nipple. We aimed to retrospectively verify whether blood flow analysis using Doppler sonography was useful for detecting the presence of Paget disease.

METHODS:

In this retrospective study, 12 patients with pathologically proven unilateral nipple eczematous lesions (seven with Paget disease and five with simple dermatitis) were included. Nipple blood flow signal was observed using Doppler sonography, and the detected blood flow signals were quantified using digitally recorded images. Quantified blood flow ratio and pathologically examined capillary density were evaluated between affected and unaffected nipples. Findings of mammography, grayscale sonography, and contrast-enhanced magnetic resonance imaging (CE-MRI) were reviewed.

RESULTS:

In patients with Paget disease, Doppler effects in the affected nipple were more clearly visible than those in the unaffected nipple. These effects were sufficiently visible to identify Paget disease. No obvious effects were observed in the affected and unaffected nipples of simple dermatitis. The quantified blood flow ratio and pathologically examined capillary density were significantly higher for the Paget lesion than those for the non-Paget lesion. The sensitivity of CE-MRI and Doppler sonography was markedly correlated, revealing blood flow changes in the nipple lesions of Paget disease.

CONCLUSION:

Doppler sonography visualized the proliferation of blood vessels in Paget lesions. The visualization of increased nipple blood flow using Doppler sonography is a simple and low-cost method that provides useful data for identifying Paget disease during routine medical care.

PMID:
29768474
PMCID:
PMC5955580
DOI:
10.1371/journal.pone.0197156
[Indexed for MEDLINE]
Free PMC Article
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3.
Gan To Kagaku Ryoho. 2017 Nov;44(12):1598-1600.

[A Case of Paget-Type Recurrence 20 Years after Breast Conserving Surgery for Invasive Ductal Carcinoma].

[Article in Japanese]

Author information

1
Dept. of Surgery, Kashiwara Municipal Hospital.

Abstract

We report an 85-year-old female suffered Paget-type recurrence at right remnant breast. The patient had undergone breast conserving surgery(BCS)20 years ago in another hospital for invasive ductal carcinoma of the right breast(pT1N0M0, Stage I ). Her chief complain was a skin ulcer of the right nipple. The pathological diagnosis for biopsy specimen from the areola was Paget's disease. She underwent total mastectomy. Paget cells were detected pathologically in the epidermis of the nipple and nearby mammary duct connected with fibrous tissue after BCS, suggesting Paget-type recurrence of invasive breast carcinoma.

PMID:
29394714
[Indexed for MEDLINE]
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4.
Diagn Pathol. 2018 Jan 25;13(1):10. doi: 10.1186/s13000-018-0688-x.

Breast implant-associated anaplastic large cell lymphoma in a Li-FRAUMENI patient: a case report.

Author information

1
Department of Anatomic Pathology, A.C. Camargo Cancer Center, 211 Professor Antônio Prudente Street, Sao Paulo, Zip code 01509-900, Brazil. ricardopastorello@hotmail.com.
2
Department of Anatomic Pathology, A.C. Camargo Cancer Center, 211 Professor Antônio Prudente Street, Sao Paulo, Zip code 01509-900, Brazil.
3
Department of Breast Surgery, A.C. Camargo Cancer Center, Sao Paulo, Brazil.
4
Department of Breast Surgery, A.C. Camargo Cancer Center, University of São Paulo, Sao Paulo, Brazil.

Abstract

BACKGROUND:

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare malignancy, recently recognized as a provisional entity by the World Health Organization. Although increasing data have been published on this entity in recent years, a great number of patients and health professionals remain unaware of this diagnosis.

CASE PRESENTATION:

We herein report the case of a 56-year-old female with Li-FRAUMENI syndrome who presented with late right-sided recurrent breast swelling after prophylactic adenomastectomy with implant reconstruction. Imaging scans revealed an heterogeneous mass adjacent to the implant fibrous capsule. A biopsy of the lesion rendered the diagnosis of a BIA-ALCL.

CONCLUSIONS:

This case presents similarities with previous reports, but also some particularities, which should be stressed in order to make the diagnosis the earliest possible. The most distinct feature is that this is the second report of BIA-ALCL arising in the setting of Li-FRAUMENI syndrome.

KEYWORDS:

Anaplastic large cell lymphoma; Anaplastic lymphoma kinase (ALK); Breast implant; Li-FRAUMENI syndrome; Lymphoma

PMID:
29370815
PMCID:
PMC5784673
DOI:
10.1186/s13000-018-0688-x
[Indexed for MEDLINE]
Free PMC Article
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5.
BMJ Case Rep. 2018 Jan 4;2018. pii: bcr-2017-222817. doi: 10.1136/bcr-2017-222817.

Invasive papillary breast cancer with Paget's disease: first reported association and literature review.

Author information

1
Breast Department, KK Women's and Children's Hospital, Singapore.
2
Duke-NUS Medical School, Singapore.
3
Department of Pathology, KK Women's and Children's Hospital, Singapore.

Abstract

Invasive papillary carcinoma of the breast and Paget's disease are both rare entities. We report the first known case of invasive papillary carcinoma associated with Paget's disease in a woman who presented clinically with a nipple mass. While invasive papillary carcinoma has been reported to have an indolent course without need for overtreatment, our patient had unusual unfavourable histological features. Literature review of this rare subtype was performed.

KEYWORDS:

breast cancer; general surgery

PMID:
29301809
DOI:
10.1136/bcr-2017-222817
[Indexed for MEDLINE]
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6.
J Fam Pract. 2017 Dec;66(12):758-760.

Erythematous, friable nipple with loss of protrusion · history of breastfeeding · Dx?

Author information

1
Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA.
2
Department of Radiology, University of Virginia School of Medicine, Charlottesville, VA, USA.
3
University of Virginia, School of Nursing, Charlottesville, VA, USA. Email: jlk2t@virginia.edu.

Abstract

A 34-year-old healthy woman presented to the breast surgical oncology clinic with skin changes to her left nipple after being referred by her primary care provider. She attributed the skin changes to shearing from breastfeeding her third child 5 years earlier. Physical examination revealed an erythematous and friable nipple with loss of protrusion. The patient reported routine bleeding from her nipple, but said the skin changes had remained stable and denied any breast masses. The patient's last mammogram was 2.5 years earlier and had only been remarkable for bilateral benign calcifications.

PMID:
29202150
[Indexed for MEDLINE]
Icon for Frontline Medical Communications Inc
7.
Pathol Res Pract. 2017 Nov;213(11):1454-1456. doi: 10.1016/j.prp.2017.06.002. Epub 2017 Jun 10.

An atypical presentation of Paget's Disease of the breast without nipple involvement: Case report and review of the literature.

Author information

1
Emory University School of Medicine, Atlanta, GA, USA. Electronic address: jbroeck@emory.edu.
2
Department of Pathology, Emory University School of Medicine, Atlanta, GA, USA.
3
Winship Cancer Institute, Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA.

Abstract

We present a case of a 63 year-old Caucasian female who developed a right breast skin lesion discrete from the nipple that was subsequently diagnosed as Paget's Disease of the breast (PDB). Imaging did not reveal an underlying breast cancer or involvement of the nipple. The patient underwent a segmental mastectomy preserving the nipple and final pathology demonstrated residual Paget's disease of the skin and did not reveal any additional underlying breast carcinoma. To our knowledge, this case represents the first reported diagnosed case of isolated PDB without nipple involvement.

PMID:
28662776
DOI:
10.1016/j.prp.2017.06.002
[Indexed for MEDLINE]
Icon for Elsevier Science
8.
Presse Med. 2017 Jun;46(6 Pt 1):626-628. doi: 10.1016/j.lpm.2017.05.004. Epub 2017 May 25.

[Hyperkeratotic lesion of the nipple and areola].

[Article in French]

Author information

1
CHU Ibn Sina, université Mohammed V, faculté de médecine et de pharmacie, dermatologie-vénérologie, Rabat, Maroc. Electronic address: aminakissou@hotmail.com.
2
CHU Ibn Sina, université Mohammed V, faculté de médecine et de pharmacie, dermatologie-vénérologie, Rabat, Maroc.
PMID:
28552486
DOI:
10.1016/j.lpm.2017.05.004
[Indexed for MEDLINE]
Icon for Elsevier Science
9.
Dermatol Online J. 2017 Apr 15;23(4). pii: 13030/qt0t89d5dg.

Paget disease of the male breast.

Author information

1
Department of Dermatology and Venereology, Centro Hospitalar São João EPE, Porto, Portugal. sofialopes88@gmail.com.

Abstract

Paget disease of the breast is an uncommon tumor of the nipple-areola complex that usually presents as an erythematous and erosive lesion. We report the case of a 61-year-old man that presented with a three-year history of an erythematous lesion of the right areola, first treated with topical corticosteroids without benefit. He was then referred to our dermatology department and the clinical suspicion of Paget disease was considered. The diagnosis was later confirmed by biopsy. This case report highlights the importance of clinical recognition of this entity along with other diseases that mimic these skin changes in order to allow earlier diagnosis and proper follow-up.

PMID:
28541881
[Indexed for MEDLINE]
10.
Am J Dermatopathol. 2017 Jun;39(6):419-427. doi: 10.1097/DAD.0000000000000704.

Diagnostic Criteria in Intraepithelial Pagetoid Neoplasms: A Histopathologic Study and Evaluation of Select Features in Paget Disease, Bowen Disease, and Melanoma In Situ.

Author information

1
*Demonstrator at the Dermatology Department, Kasralainy Faculty of Medicine, Cairo, University, Egypt; †Visiting Research Fellow, Ackerman Academy of Dermatopathology, New York, NY; ‡Attending Dermatologist, Department of Dermatology, Dermatology Hospital of Southern Medical University, Guangdong Provincial Dermatology Hospital, China; §Junior Specialist, Department of Dermatology, University of California, Irvine, CA; ¶Attending Dermatologist, Department of Dermatology, Jose R. Reyes Memorial Medical Center, Manila; ‖Medical Student, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; #Professor of Biostatistics, Department of Biostatistics and Epidemiology, National Cancer Institute, Cairo University, Cairo, Egypt; **Dermatopathologist, Dermpath Diagnostics New York, Port Chester, NY; and ††Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, SC.

Abstract

BACKGROUND:

Paget disease, Bowen disease, and malignant melanoma in situ are intraepidermal neoplasms, characterized by the presence of pagetoid scatter of atypical cells in the epidermis. This study reviewed the frequency of select histologic criteria to validate their usefulness in the histologic distinction between these entities.

METHODS:

One hundred forty-four specimens with the diagnosis of Bowen disease, 144 specimens with Paget disease (mammary and extramammary), and 144 specimens with malignant melanoma in situ were examined microscopically to define frequencies of select histologic criteria present in each disease.

RESULTS:

Comparison between mammary Paget and extramammary Paget disease showed no significant differences in the features studied. Crushing of basal keratinocytes, presence of atypical cells in the corneum, and presence of large cells with amphophilic cytoplasm were significantly noted in Paget disease. Transition between the atypical clear cells and surrounding keratinocytes was absent in all cases of melanoma in situ and in 87 (60.4%) cases of Paget disease, but it was significantly associated with Bowen disease (98.6%). Dyskeratotic cells were significantly associated with Bowen disease cases.

CONCLUSION:

Our study demonstrated a practical histologic approach to differentiate between intraepidermal pagetoid neoplasms. Careful histologic study of the proposed criteria may reduce reliance on immunohistochemical stains.

PMID:
28525420
DOI:
10.1097/DAD.0000000000000704
[Indexed for MEDLINE]
Icon for Wolters Kluwer
11.
Zhonghua Yi Xue Za Zhi. 2017 Apr 11;97(14):1076-1078. doi: 10.3760/cma.j.issn.0376-2491.2017.14.010.

[Clinicopathological features of acantholytic mammary Paget's disease: a report of 28 cases].

[Article in Chinese; Abstract available in Chinese from the publisher]

Author information

1
Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.

Abstract

Objective: To investigate the clinicopathological features of acantholytic mammary Paget's disease (AMPD). Methods: From January, 2010 to October, 2016, a total of 28 patients were diagnosed as AMPD in the Department of Dermatology, Peking Union Medical College Hospital. The clinical and histopathological data of these patients were analyzed retrospectively. Results: The patients were all female. The mean age of onset was (51±15)years (range, 24 to 78 years). The median course of disease was 10.5 months (range, 3 months to 2 years). All the cases were unilaterally involved. The ratio of left breast involvement to the right breast involvement was 1.55∶1. In histopathological examination, all the cases showed acantholytic pattern. In addition to that, the prototypical pattern accounted for 50.0% (14/28) of all the AMPD cases. The frequencies of other different accompanied histopathological patterns were: 3 (10.7%) upper nest, 2 (7.1%) budding, 1 (3.6%) tall nest, and 1 (3.6%) sheet-like. Hailey-Hailey-disease-like acantholysis was observed in 18 patients (64.3%), whereas pemphigus-vulgaris-like acantholysis was noted in 7 patients (25.0%) and Darier's-disease-like acantholysis in 3 patients (10.7%). About 75.0% (21/28) of the AMPD cases were found to be accompanied with underlying breast cancers. There was no recurrence in 18 of 20 patients who completed treatment and were followed up for over 1 year. Conclusions: AMPD might involve the left breast more frequently. It is mostly associated with the prototypical pattern of mammary Paget's disease. Hailey-Hailey-disease-like acantholysis may be the most frequent subtype of AMPD. Most AMPD cases are associated with underlying breast cancers, but with a low recurrence rate after treatment.

KEYWORDS:

Acantholysis; Clinicopathological features; Paget′s disease, mammary

PMID:
28395432
[Indexed for MEDLINE]
Icon for Chinese Medical Association Publishing House Ltd.
12.
G Ital Dermatol Venereol. 2017 Feb;152(1):77-80. doi: 10.23736/S0392-0488.16.05159-2.

Mammary pigmented Paget's disease in a male: a diagnostic challenge.

Author information

1
Section of Dermatology, Department of Medical Sciences, University of Ferrara, Arcispedale S. Anna, Ferrara, Italy.
2
Section of Dermatology, Department of Medical Sciences, University of Ferrara, Arcispedale S. Anna, Ferrara, Italy - czm@unife.it.
3
Section of Anatomy, Histology and Pathological Cytology, University of Ferrara, Ferrara, Italy.
PMID:
27978609
DOI:
10.23736/S0392-0488.16.05159-2
[Indexed for MEDLINE]
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13.
Am J Surg. 2017 Feb;213(2):426-432. doi: 10.1016/j.amjsurg.2016.05.018. Epub 2016 Jul 21.

Characteristics and treatment of human epidermal growth factor receptor 2 positive breast cancer: 43,485 cases from the National Cancer Database treated in 2010 and 2011.

Author information

1
Department of Surgery, Yale University School of Medicine, The Breast Center, Smilow Cancer Hospital at Yale-New Haven, 20 York Street North Pavilion, First Floor, New Haven, CT 06510, USA. Electronic address: brigid.killelea@yale.edu.
2
Department of Surgery, Yale University School of Medicine, The Breast Center, Smilow Cancer Hospital at Yale-New Haven, 20 York Street North Pavilion, First Floor, New Haven, CT 06510, USA.

Abstract

BACKGROUND:

Although identification of human epidermal growth factor receptor 2 (Her2) positive breast cancer represents one of the greatest advances over the past 3 decades, it has not been studied extensively on a national level.

METHODS:

The National Cancer Database is a joint project of the American Cancer Society and the American College of Surgeons and contains data on about 70% of the cancer cases in the United States. Data on Her2 have been collected since 2010 and was used for this study.

RESULTS:

Of 298,937 cases of invasive breast cancer with known Her2 status diagnosed in 2010 and 2011, 43,485 (14.5%) were Her2 positive. Her2 positivity was greatest in Asian/Pacific Islanders and least in non-Hispanic Whites and was markedly more common in younger women. The incidence of Her2 positive tumors ranged from a low of 13.9% in the Mountain West region to a high of 16.0% in the West South Central region (P < .001). Compared with Her2 negative tumors, Her2 positive tumors were larger (2.6 vs 2.2 cm, P < .001), more likely to have positive nodes (39% vs 31% P < .001), have lymphovascular invasion (30% vs 20%, P < .001), and be high grade (56% vs 29%, P < .001). There were also differences by histology: invasive ductal 16.4%, invasive lobular 5.5%, tubular 2.3%, inflammatory 36%, and Paget's with invasion 59%. When adjusted for age, race, tumor size, and nodal status Her2 positive tumors were much more likely to receive chemotherapy (odds ratio = 5.5, confidence interval = 5.2 to 6.0) and somewhat less likely to undergo breast preservation (odds ratio = .78, confidence interval = .76 to .80).

CONCLUSIONS:

Her2 positive tumors have distinct epidemiologic, clinical, and treatment characteristics.

KEYWORDS:

Breast cancer; Breast cancer epidemiology; Breast cancer treatment; Her2 positive breast cancer

PMID:
27769548
DOI:
10.1016/j.amjsurg.2016.05.018
[Indexed for MEDLINE]
Icon for Elsevier Science
14.
Dermatol Clin. 2016 Oct;34(4):443-458. doi: 10.1016/j.det.2016.05.007.

Enlightening the Pink: Use of Confocal Microscopy in Pink Lesions.

Author information

1
SkinMedical Research and Diagnostics, PLLC, 64 Southlawn Ave., PO Box 42, Dobbs Ferry, NY 10522, USA. Electronic address: mgill@skinmedicalranddx.com.
2
Medicine and Medical Specialities Department, Medicine and Health Sciences Faculty, Alcalá University, Univeristy Campus, National road II, 28871- Alcalá de Henares, Madrid, Spain; Dermatology Service, Memorial Sloan-Kettering Cancer Center, 16 E 60th Street, New York, NY 10022, USA.

Abstract

Solitary pink lesions can pose a particular challenge to dermatologists because they may be almost or completely featureless clinically and dermoscopically, previously requiring biopsy to exclude malignancy. However, these lesions usually are not particularly challenging histopathologically. Thus, the incorporation of in vivo reflectance confocal microscopy into the clinical practice, which allows for noninvasive examination of the skin at the cellular level revealing features previously seen only on histopathology, is particularly useful for this subset of clinically difficult lesions.

KEYWORDS:

Amelanotic melanoma; Dermoscopy; Nevi; Noninvasive diagnostics; Nonmelanoma skin cancer (NMSC); Pink skin tumors; Reflectance confocal microscopy (RCM)

PMID:
27692450
DOI:
10.1016/j.det.2016.05.007
[Indexed for MEDLINE]
Icon for Elsevier Science
15.
Magy Seb. 2016 Sep;69(3):117-32. doi: 10.1556/1046.69.2016.3.5.

[Modern surgical treatment of breast cancer. 3rd Breast Cancer Consensus Conference].

[Article in Hungarian]

Author information

1
Sebészeti Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar 6725 Szeged, Semmelweis út 8.
2
Sebészeti-Onkosebészeti Osztály, Fővárosi Önkormányzat Uzsoki Utcai Kórház Budapest.
3
Sebészet, Állami Egészségügyi Központ Budapest.
4
I. Sz. Sebészeti Klinika, Semmelweis Egyetem Budapest.
5
Sebészeti Intézet, Debreceni Egyetem Debrecen.
6
Bács-Kiskun Megyei Önkormányzat Kórháza Kecskemét.
7
Országos Onkológiai Intézet Budapest.
8
Sebészeti Klinika, Pécsi Tudományegyetem Pécs.

Abstract

Therapy for breast cancer today is characterised by ever more precise diagnostic methods and ever more effective oncological treatments, a trend which will certainly continue into the future. Breast preservation and the application of oncoplastic principles are increasingly popular. A sentinel lymph node biopsy in the surgical treatment of the axilla is primary, with the indication for axillary block dissection (ABD) narrowing and radiation therapy becoming an alternative to ABD in certain cases. This publication summarises our recommendations on the surgical treatment of breast cancer based on the content of the 3rd Breast Cancer Consensus Conference and considering the latest international studies and professional recommendations.

KEYWORDS:

emlőráksebészet; oncoplastic principles; onkoplasztika; sentinel lymph node; surgical therapy of breast cancer; őrszemnyirokcsomó

PMID:
27644928
DOI:
10.1556/1046.69.2016.3.5
[Indexed for MEDLINE]
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16.
Breast J. 2016 Nov;22(6):693-695. doi: 10.1111/tbj.12660. Epub 2016 Aug 4.

Extensive Lobular Carcinoma In Situ with Pagetoid Spread into Multiple Papillomas of the Breast.

Author information

1
Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
2
Division of Breast and Endocrine Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
PMID:
27488817
DOI:
10.1111/tbj.12660
[Indexed for MEDLINE]
Icon for Wiley
17.
Breast. 2016 Oct;29:14-23. doi: 10.1016/j.breast.2016.06.015. Epub 2016 Jul 6.

Paget's disease of the male breast in the 21st century: A systematic review.

Author information

1
College of Medicine, University of Saskatchewan, B526 Health Sciences Building, 107 Wiggins Road, Saskatoon, Saskatchewan S7N 5E5, Canada. Electronic address: scott.adams@usask.ca.
2
Department of Pathology and Laboratory Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, Saskatchewan S7N 0W8, Canada. Electronic address: rani.kanthan@saskatoonhealthregion.ca.

Abstract

Paget's disease of the breast is characterized by eczematous changes of the nipple-areolar complex and is associated with an underlying in situ or invasive breast carcinoma in most cases. Histologically, Paget's disease is identified by epithelial cells with abundant basophilic or amphophilic, finely granular cytoplasm with a large, centrally situated nucleus, most abundant in the lower epidermal layers. Due to the rarity of the condition among breast cancers, compounded by the rarity of breast cancer in men, understanding of the disease's presentation, course, and optimal treatment in men is largely derived from case reports and extrapolation of findings from studies in female patients. Paget's disease must be differentiated from other conditions including eczema, Bowen's disease, squamous cell carcinoma, and melanoma. Recognition of Paget's disease clinically and pathologically is critical as the superficial lesion may be the only sign of an underlying ductal carcinoma and its presence may be of prognostic significance. This article provides an update on cases of Paget's disease of the breast in men reported in the published literature together with a comprehensive analysis of the National Cancer Institute's Surveillance, Epidemiology, and End Results Data, 1973-2012. Current understanding and management of the disease in the context of male patients is reviewed. However, additional research is required to further understand the overall pathogenesis and molecular profile of Paget's disease to provide improved insight for personalized, precision-based therapeutic options.

KEYWORDS:

Breast cancer; Male breast cancer; Paget's disease

PMID:
27394005
DOI:
10.1016/j.breast.2016.06.015
[Indexed for MEDLINE]
Icon for Elsevier Science
18.
J Biol Regul Homeost Agents. 2016 Apr-Jun;30(2):589-92.

An unusual case of mammary Paget’s disease in a woman with psoriasis.

Author information

1
Department of Experimental and Clinical Medicine-Radiology, University Magna Græcia, Catanzaro, Italy.
2
Department of Health Sciences, Operative Unit of Dermatology, University Magna Græcia, Catanzaro, Italy.

Abstract

Mammary Paget’s disease (MPD) is a malignant breast tumor, which is characterized by intraepidermal infiltration from malignant glandular epithelial cells. Often it may include an underlying ductal carcinoma in situ or an invasive ductal carcinoma. Clinically it appears as an erythematous patch, moist or crusted, with or without desquamation that in some cases becomes ulcerated, causing infiltration and inversion of the nipple. We report the clinical case of a 60-year-old woman, treated in our department for psoriasis, presenting with erythema of nipple and areola with nipple erosion, ulceration and poor secretion. Suspecting Paget’s disease of the nipple, radiological exams (mammography and breast MRI) were performed. A biopsy for histological examination was carried out and confirmed the diagnosis of mammary Paget’s disease. MPD is sometimes difficult to diagnose both clinically and radiologically, therefore it is important to distinguish from other conditions: in literature MPD is reported in differential diagnosis with psoriasis given its similar clinical features, and in some cases MPD has been treated with topical and systemic steroids due to a wrong diagnosis. However, the concomitance, in the same individual, of mammary Paget’s disease and psoriasis has never been described.

PMID:
27358153
[Indexed for MEDLINE]
19.
Acta Derm Venereol. 2016 Nov 2;96(7):980-982. doi: 10.2340/00015555-2402.

Reflectance Confocal Microscopy for Diagnosis of Mammary Paget's Disease.

Author information

1
Department of Dermatology, Hospital de Santo António dos Capuchos - Centro Hospitalar de Lisboa Central, 1169-050 Lisboa, Portugal. andre.oliveira@sapo.pt.
PMID:
26976808
DOI:
10.2340/00015555-2402
[Indexed for MEDLINE]
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20.
Pathol Res Pract. 2016 Apr;212(4):279-81. doi: 10.1016/j.prp.2016.01.004. Epub 2016 Jan 22.

Cytokeratin 7-negative mammary Paget's disease: A diagnostic pitfall.

Author information

1
Department of Pathology, Yale University School of Medicine, PO Box 208023, New Haven, CT 06520-8023, USA.
2
Department of Pathology, Yale University School of Medicine, PO Box 208023, New Haven, CT 06520-8023, USA. Electronic address: fattaneh.tavassoli@yale.edu.

Abstract

Pathologists should be aware of the existence of a rare CK7-negative variant of breast carcinoma in general, and of Paget's disease in particular. Cytokeratin 7-negative Paget's disease and CK7-negative ductal intraepithelial neoplasia (ductal carcinoma in situ) present a major diagnostic challenge for pathologists since there is limited awareness of their existence. When there is classic Paget's morphology on H&E sections, GATA3 positivity should resolve any doubts about the diagnosis in the setting of a CK7-negative neoplastic cell population.

KEYWORDS:

Breast; CK7; Cancer; GATA3; Paget's disease

PMID:
26944832
DOI:
10.1016/j.prp.2016.01.004
[Indexed for MEDLINE]
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