The American Journal of Surgery
Volume 200, Issue 2 , Pages 241-246, August 2010

Surgical treatment in Paget's disease of the breast

  • Elina Siponen, M.D.

      Affiliations

    • Breast Surgery Unit, Helsinki University Central Hospital, Helsinki, Finland
    • Corresponding Author InformationCorresponding author: Tel.: 358-40-550-93-88; fax: 358-09-47176301
    • ,
  • Katja Hukkinen, Ph.D.

      Affiliations

    • Department of Radiology, Helsinki University Central Hospital, Helsinki, Finland
    • ,
  • Päivi Heikkilä, Ph.D.

      Affiliations

    • Department of Pathology, Helsinki University Central Hospital, Helsinki, Finland
    • ,
  • Heikki Joensuu, Ph.D.

      Affiliations

    • Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland
    • ,
  • Marjut Leidenius, Ph.D.

      Affiliations

    • Breast Surgery Unit, Helsinki University Central Hospital, Helsinki, Finland

Received 17 June 2009; received in revised form 8 July 2009

Abstract 

Background

The aim of this study was to evaluate the outcomes of surgical treatment of Paget's disease of the breast, with special emphasis on magnetic resonance imaging (MRI) and sentinel node biopsy (SNB).

Methods

The study included 58 consecutive patients with Paget's disease treated from 1995 to 2006.

Results

Twenty-five patients had ductal carcinoma in situ, and 31 had invasive carcinoma. MRI was performed in 14 patients, with positive findings in 7 patients, 5 of whom had negative findings on conventional imaging. The overall mastectomy rate was 76%. Eighteen patients underwent SNB, and 26 patients underwent full or partial axillary clearance. Fourteen patients had no axillary surgery. One patient had local recurrence after breast conservation, and another had axillary recurrence after negative results on SNB. Six patients had distant metastases. Four patients died of breast cancer.

Conclusions

Paget's disease is frequently associated with peripheral or multicentric cancer. MRI may be helpful when considering breast conservation or omitting axillary nodal staging.

Keywords: Paget's disease, Breast cancer, Local recurrence, MRI, Sentinel node biopsy

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 This study was supported by a grant from the Helsinki University Central Hospital Research Fund (Helsinki, Finland).

PII: S0002-9610(09)00671-0

doi:10.1016/j.amjsurg.2009.07.044

The American Journal of Surgery
Volume 200, Issue 2 , Pages 241-246, August 2010

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