Invasive Paget disease of the nipple: a brief review of the literature and report of the first case with axillary nodal metastases.

TitleInvasive Paget disease of the nipple: a brief review of the literature and report of the first case with axillary nodal metastases.
Publication TypeJournal Article
Year of Publication2014
AuthorsOzerdem U, Swistel A, Antonio LB, Hoda SA
JournalInt J Surg Pathol
Volume22
Issue6
Pagination566-9
Date Published2014 Sep
ISSN1940-2465
KeywordsAged, Axilla, Breast Neoplasms, Carcinoma, Ductal, Breast, Female, Humans, Lymphatic Metastasis, Neoplasms, Second Primary, Nipples, Paget's Disease, Mammary
Abstract

Although Paget disease of the nipple (PDN) is a well-established clinical and pathological neoplastic process, invasive PDN (IPDN) is a relatively newly described disease. The latter entity is characterized by invasive carcinoma that is localized to the nipple and is associated with PDN as well as with either intraductal and/or invasive carcinoma in the underlying breast. To our knowledge, only 17 cases of IPDN, all node negative, have been reported. Here, we report the case of a 68-year-old woman with invasive Paget disease of the left nipple. The patient had a history of intraductal carcinoma, treated by lumpectomy alone. She presented 6 years later with "eczematous" lesion of the ipsilateral nipple, a punch biopsy of which showed a superficially IPDN as well as conventional PDN. The subsequently performed wide excision of the nipple, areola, and underlying breast tissue showed the invasive carcinoma to span 0.6 cm. Then, 3 months later, the patient presented with ipsilateral palpable axillary lymphadenopathy. Axillary dissection revealed metastatic carcinoma in 7 of 19 lymph nodes. This case of IPDN not only represents the deepest extent of invasion reported thus far but also the only one known to be node positive.

DOI10.1177/1066896914525229
Alternate JournalInt J Surg Pathol
PubMed ID24583835
Related Faculty: 
Syed Hoda, M.D.

Pathology & Laboratory Medicine 1300 York Avenue New York, NY 10065 Phone: (212) 746-6464
Surgical Pathology: (212) 746-2700