Cancer Paget's Disease of the Breast

In Paget's disease of the breast, malignant cells are present in the glandular epithelium in the mammary papilla, causing scaly or erosive lesions at the site. It may or may not be related to intramammary carcinoma.
This disease is uncommon, being the first sign of breast cancer by only 0.5 to 4.3% of all cases. Almost always occurs in one breast only. Very rarely affects women under age 30 years, being more common over age 50.
Usually begins with the appearance of erythematous and squamous lesions, similar to eczema or psoriasis, in a mammary papillae. There may be local burning or itching, and in some cases, bleeding occurs. While the process progresses, there may be reversed, thickening, erosion or ulceration of the nipple and areola to the extent of the lesion. In approximately 50% of cases there is the presence of palpable breast lump.
The tests recommended for the diagnosis is mammography and breast ultrasound. Although not present specific findings are of great importance in the search for lumps or calcifications. Magnetic resonance imaging can increase the sensitivity of diagnosis is recommended in cases of surgical indication, to exclude the possibility of occult foci carcinogenic.
The differential diagnosis of the lesion should be done especially with eczema and contact dermatitis.
The definitive diagnosis is made by biopsy of the mammary papilla. When palpable nodules are present, they should be biopsied, and suspicious regions detected by imaging.
Treatment
The treatment for this type of anomaly has always been mastectomy, taking into account the possibility of extensive lesions, multifocal or multicentric. Cure rates described reach almost 100%. However, now considered the possibility of segmental resection of the breast, preceded by radiotherapy for early carcinomas. When choosing the conservative procedure, you must completely remove papillary-areola complex.
Diagnosis
The exams are recommended a mammogram and a biopsy to confirm the diagnosis. A cytological examination can also be helpful.