Dubar S, Boukrid M, Bouquet de Joliniere Jean, Guillou L, Vo Quoc Duy, Major A, Ali N Ben, Khomsi F, Feki A
Department of Gynecology-Obstetric, Cantonal Hospital of Fribourg, Fribourg, Switzerland.
Front Surg. 2017 Oct 23;4:51. doi: 10.3389/fsurg.2017.00051. eCollection 2017.
Paget's disease of the breast is a rare cancer. This typical clinical case illustrates the different epidemiological, clinical, histological, therapeutic, and evolving aspects of the disease. We report a case of Paget's disease in a 43-year-old woman who presented eczema of the nipple. Mammography and ultrasounds did reveal a lesion . The patient was scheduled for mastectomy and sentinel node biopsy. She had chosen a radical bilateral surgery. The histological diagnosis was Paget's disease of the breast with a carcinoma . There was no metastasis in either of the sentinel nodes. Paget's disease must be considered with the presence of a persistent eczematous involvement of the nipple, which does not respond to local treatment. Ultrasounds, mammography, and magnetic resonance imaging can allow searching an underlying cancer and guiding the surgical management. There is no evidence at this time that one of the two surgical techniques (conservative or mastectomy) would improve survival. The prognosis depends on the presence of a palpable mass and the invasiveness of the cancer.
乳腺佩吉特病是一种罕见的癌症。这个典型的临床病例阐述了该疾病在流行病学、临床、组织学、治疗及演变方面的不同情况。我们报告一例43岁患有乳头湿疹的女性佩吉特病病例。乳房X线摄影和超声检查确实发现了一个病灶。该患者计划接受乳房切除术和前哨淋巴结活检。她选择了根治性双侧手术。组织学诊断为乳腺佩吉特病伴癌。前哨淋巴结均无转移。当乳头存在持续性湿疹样病变且局部治疗无效时，必须考虑佩吉特病。超声、乳房X线摄影和磁共振成像有助于查找潜在癌症并指导手术治疗。目前没有证据表明两种手术技术（保乳手术或乳房切除术）中的任何一种能提高生存率。预后取决于是否可触及肿块以及癌症的侵袭性。
