Clinical and Pathological Analysis of Paget' s Disease

Objective:To explore the mechanism, clinical features, treatment and prognosis of Paget's disease. Methods:A total of 48 Paget's disease cases diagnosed and treated in our hospital between 1998 and 2008 were retrospectively reviewed. Results:The average age of these 48 patients was 56.5 years. Twenty-four cases presented with a single symptom of nipple-areola complex erosion and scab, while 11 cases had nipple-areola complex erosion and nipple discharge, 5 cases had nipple recovery or disappearance, and 3 cases had pruritus. Two cases were diagnosed based on a lump and 3 cases were diagnosed on the basis of nipple erosion and a lump. Of these 48 cases, 38 also had breast cancer, 34 of which were ductal carcinoma in situ and 4 of which were invasive ductal carcinoma. Ten cases were simple Paget's disease. Thirty-eight cases underwent mastectomy, 7 cases received breast and low axillary lymph node dissection and 1 case received simple breast adenectomy. Two cases had no treatment. Of the 48 cases, 7 had positive expression of ER and PR and 19 cases had positive expression of Her-2. Conclusion:Most breast Paget's disease cases were combined with ductal carcinoma in situ or with invasive ductal carcinoma. Paget's disease cases with breast lumps are more likely to have invasive ductal carcinoma. Invasive carcinoma tumors usually express ER and Her-2 and do not express PR, suggesting a poor prognosis and an immediate need for appropriate treatment.