Bandara I M H W, Somathilaka S P D U, Gajanthan K and Udayakumara E A D
Accepted Abstracts: Surgery Curr Res
Introduction: Paget?s disease is a type of breast cancer that occurs in the ducts adjacent to the nipple-areola complex and spreads to the skin. The diagnosis remains elusive with varied presentations, mimicking many benign skin diseases, the awareness of which is necessary for the diagnosis. A case of Paget's disease of the nipple, with underlying ductal carcinoma insitu(DCIS) is reported. Case report: A 52 year old female presented with a complaint of reddish itchy, oozylesion on her left breast which wasgradually progressed over 3 months. There was no history of nipple dischargeand family history was unremarkable.On examination, she had an erythematous ulcerated plaque covering the nipple-areola complex with hemorrhagic crusts over the left breast. A single mobile lymph node was palpable in the left axilla.The fine needle aspiration was inconclusive. The patient underwent total mastectomy with level II axillary node clearance. The surgical specimen confirmed Paget's disease limited to the epidermis with ductal carcinoma in-situ in the underlying breast tissue. Patient referred to oncologist for further management. Discussion: Management of Paget?s disease of breast depends on whether it is confined to the skin or associated withunderline breast tissue involvement. As regards to the therapy, simple mastectomy with or without axillary clearance has been the historic standard treatment if it is confine to the skin. Presence of underline breast tissue involvement warrants total mas tectomy with axillary clearance. In conclusion any chronic eczematous lesion over the breast should be thoroughly evaluated both clinically as well as histologically to rule out malignancy.
