Sakorafas G H, Blanchard D K, Sarr M G, Farley D R
Department of Surgery, 251 Hellenic Air Force Hospital, Athens, Greece.
Langenbecks Arch Surg. 2001 Nov;386(6):444-50. doi: 10.1007/s004230100250. Epub 2001 Oct 17.
Paget's disease of the breast is a rare disorder of the nipple-areola complex often associated with an underlying in situ or invasive carcinoma. Eczematoid changes of the nipple-areola complex and persistent soreness or itching should raise suspicion of this disease. The histogenesis of Paget's disease of the breast continues to be debated and is important when considering treatment options. The epidermotropic theory suggests that Paget's cells are ductal carcinoma cells that have migrated from an underlying carcinoma of the breast parenchyma to the epidermis of the nipple. The in situ transformation theory has been proposed to explain the development of this disorder in patients in whom an underlying mammary carcinoma is not found or when there is an underlying carcinoma anatomically remote from the nipple-areola complex. Paget's cells are believed to arise as malignant cells in the epidermis of the nipple independent from any other pathologic process within the breast parenchyma. The current standard treatment of biopsy-proven Paget's disease involves mastectomy, although some studies have proposed the use of breast conservation therapy for patients in whom an underlying breast cancer cannot be located. We propose a treatment algorithm for patients presenting with Paget's disease of the breast.
乳腺佩吉特病是一种罕见的乳头乳晕复合体疾病，常与潜在的原位癌或浸润性癌相关。乳头乳晕复合体的湿疹样改变以及持续的疼痛或瘙痒应引起对该病的怀疑。乳腺佩吉特病的组织发生仍存在争议，在考虑治疗方案时很重要。表皮趋向性理论认为，佩吉特细胞是从乳腺实质的潜在癌转移至乳头表皮的导管癌细胞。原位转化理论已被提出，用于解释在未发现潜在乳腺癌或潜在癌在解剖学上远离乳头乳晕复合体的患者中这种疾病的发生。佩吉特细胞被认为是乳头表皮中的恶性细胞，独立于乳腺实质内的任何其他病理过程产生。经活检证实的乳腺佩吉特病的当前标准治疗方法是乳房切除术，尽管一些研究提出对于无法定位潜在乳腺癌的患者可采用保乳治疗。我们为患有乳腺佩吉特病的患者提出一种治疗算法。
