Paget's Disease Of The Nipple

Question 1

What is Paget’s disease of the nipple?

Answer 1

Eczematoid change of nipple associated with an underlying breast malignancy

Question 2

It is present in what percentage of those with breast cancer?

Answer 2

1-2%

Question 3

It is associated with..

Answer 3

An underlying mass lesion - 90% will have invasive carcinoma.
30% of those without a mass lesion will still be found to have an underlying carcinoma, the remainder will have carcinoma in situ .

Question 4

How is it different from eczema of the nipple?

Answer 4

It involves the nipple primarily and only latterly spreads to the areolar (the opposite occurs in eczema)

Question 5

What symptoms and signs occur?

Answer 5

Itching 
Redness 
Crusting
Roughening  
Slight ulceration 
Discharge from nipple

Question 6

Microscopically there is involvement of …

Answer 6

The epidermis by malignant ductal carcinoma cells

Question 7

What can occur around the nipple?

Answer 7

Flaming and thickened skin

Question 8

Is it painful?

Answer 8

Yes the area often painful and sensitive

Question 9

Given association with malignancy what should be done?

Answer 9

Breast and axilla examination
Imaging
Biopsy