Paget's Disease of The Nipple Flashcards
What is Paget’s disease of the nipple?
It is defined by epidermis involvement by malignant ductal carcinoma cells
What condition is associated with Paget’s disease of the nipple?
Breast cancer
Describe the pathophysiology of Paget’s disease of the nipple
The malignant cells migrate from the ducts to the nipple surface
OR
The cells of the nipple themselves become malignant
What are the five clinical features of Paget’s disease of the nipple?
Nipple Itching
Nipple Redness
Nipple Discharge
Nipple Pain
Skin Changes
Describe the rash associated with Paget’s disease of the nipple
The rash starts on the nipple and spreads outwards to the areola region, it does not extend beyond nipple areola complex
It appears rough, dry, erythematous, and ulcerated
Describe the discharge associated with Paget’s disese of the nipple
It is described as blood stained
What is the most appropriate step in suspected Paget’s disease of the nipple?
Urgent breast clinic referral
What investigations are used to diagnose Paget’s disease? Why?
Triple Assessment
This is due to its association with breast cancer
What is tripple assessment?
Breast Examination
Imaging (Mammogram, US, MRI)
Biopsy (FNA, Needle Core)
What is the features of Paget’s disease of the nipple on histology?
There are large-pale staining cells within the epidermis of the nipple
These cells can either be limited to the nipple or extend to the areola
How do we manage Paget’s disease of the nipple?
We conduct surgical excision, in which the nipple and areola are removed
What other condition does presents similarly to Paget’s disease of the nipple?
Eczema
