Mammary Paget’s disease (MPD) is a malignant neoplasm that unilaterally involves the nipple or areola and simulates a chronic eczematous dermatitis; it is associated with underlying intraductal carcinoma of the breast.
Causes of Mammary Paget’s Disease
Mammary Paget’s Disease is always associated with an underlying carcinoma of the breast. The dermatosis reflects epidermotropism with spread of ductal carcinoma cells through the lactiferous ducts and ductules to the surface epidermis. By thorough histologic examination, Muir documented intraepidermal extension of malignant ductal epithelial cells from underlying breast tissue into the epidermis. The findings are the basis of the epidermotropic theory of mammary PD.
Symptoms of Mammary Paget’s Disease
- Crusting, bleeding, or ulceration of the skin of the affected area
- Turning inward (inversion) of the nipple
- Red scaly patches of skin on the nipple and sometimes also on the dark area of skin around the nipple (areola)
- A discharge of fluid from the nipple
Diagnosis
Clinical findings confirmed by biopsy findings.
Treatment
Surgery, radiotherapy, and/or chemotherapy as in any other breast carcinomas. Lymph node dissection if regional nodes are palpable.
Prevention
To prevent Paget’s disease of the breast from occurring if the underlying cause is diagnosed and successfully treated prior to the development of Paget’s disease of the breast.
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