Paget’s Disease Of The Breast: Clinical-Pathological Findings And Surveillance

Aim: In this study we aimed to examine the clinicopathological findings and surveillance of patients with Paget’s disease of the breast (PD). Materials and Method: The medical records of 49 patients diagnosed and treated with PD at Başkent University Faculty of Medicine, General Surgery Clinic between January 2013 and October 2018 were retrospectively analyzed. Results: Mean age of the patients was 52.9±13.6 (26-90). The majority of the patients were women (n:45, 91.8%). The most frequent symptom at the time of admission was palpable mass (n:22, 44.9%). Modified radical mastectomy (MRM) was performed in 31 patients (63.3%), simple mastectomy in 16 patients (32.6%) and breast conserving surgery in 2 patients (4.1%). Sentinel lymph node biopsy (SLNB) in 7 (14.2%) patients and axillary lymph node dissection was performed in one patient. Invasive ductal carcinoma constituted the major histology concomitant with Paget Disease (89.8%). Lymph node involvement (LNI) was present in 29 (59.2%) patients. Palpable mass noticed by the patient and mass size over 20 mm was statistically associated with LNI (p:0.004 for both). Over 50 years of age was associated with a lower recurrence free survival (RFS) (39.2 months vs 64.1 months, p:0.012). RFS was lower in Her2 negative patients (p:0.002). Conclusion: PD is rare, it is an important disease that should not be missed. Although Her2 positivity is generally considered as a poor prognostic factor in breast cancers, we think that those with Her2 negativity may also have a poor prognosis in PD.