Breast Cancer Group, Surgical Oncology Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
Breast. 2011 Dec;20(6):515-8. doi: 10.1016/j.breast.2011.05.010.
The standard treatment for Paget's disease of the breast is mastectomy. Since it is frequently associated with underlying carcinoma, many surgeons are reluctant to choose breast conserving surgery for Paget's disease.
We retrospectively analyzed a series of 59 patients with Paget's disease who had undergone mastectomy at the National Cancer Center Hospital between 1963 and 2009.
In 55 of 59 cases (93%) there was underlying carcinoma in the ipsilateral breast. Clinically, 27 (46%) patients had no evidence of other tumors, but 23 (85%) had underlying histopathologically confirmed carcinoma. Based on the data from this subset, cone excision with a 3-cm radius and a 4-cm radius could completely resect any underlying malignancy in 74% and 85% of patients, respectively.
As Paget's disease is frequently accompanied by underlying intraductal and/or invasive carcinoma, patients should be carefully selected for breast conserving surgery.
乳房派杰氏病的标准治疗方法是乳房切除术。由于它常伴有潜在的癌，许多外科医生不愿意选择乳房保留手术来治疗派杰氏病。
我们回顾性分析了 1963 年至 2009 年期间在国立癌症中心医院接受乳房切除术的 59 例派杰氏病患者。
在 59 例中的 55 例（93%）同侧乳房有潜在癌。临床上，27 例（46%）患者无其他肿瘤证据，但 23 例（85%）有潜在组织病理学证实的癌。根据该亚组的数据，以 3cm 和 4cm 为半径的锥形切除术可以分别完全切除 74%和 85%患者的任何潜在恶性肿瘤。
由于派杰氏病常伴有导管内和/或浸润性癌，因此应仔细选择患者进行乳房保留手术。
