Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + • Infiltrating ductal carcinoma involving the nipple epithelium +++ Epidemiology + • 1% of all breast cancers• No age group predilection• Changes may be limited to the nipple, extend to the areola, or to the skin around the areola• 50-60% have a palpable tumor• If lesion is confined to nipple only, axillary metastases present in only 5% of patients• Paget disease of the breast has been associated with breast carcinoma developing in males who had Klinefelter syndrome +++ Symptoms and Signs + • Burning and pruritus of the nipple• Superficial erosion or ulceration of the nipple• Serous or bloody nipple discharge• Nipple retraction +++ Imaging Findings + • Mammography may show thickening of the nipple, calcifications, or lesion anywhere in the breast +++ Rule Out + • Inflammatory breast carcinoma + • Complete history and physical exam• Bilateral mammogram• Biopsy of the nipple erosion + • Multimodality treatment is the same as for carcinoma of the female breast +++ Surgery +++ Indications + • May consider excision of nipple-areola complex alone if no palpable tumor and no extensive disease visualized on mammogram +++ Treatment Monitoring + • Self breast exams• Semiannual clinical breast exam• Annual mammogram +++ Complications + • Edema of the arm• Metastatic spread +++ Prognosis + • Disease is manifestation of mammary carcinoma, and thus prognosis is determined by extent of associated carcinoma• No underlying mass and treated by modified radical mastectomy, 10-year survival is 82-100%• Palpable invasive tumor, but node negative, treated with modified radical mastectomy, 10-year survival is 70% +++ References ++Chen CY et al: Paget disease of the breast: changing patterns of incidence, clinical presentation, and treatment in the U.S. Cancer 2006;107:1448. [PubMed: 16933329] +++ Practice Guidelines + • The National Comprehensive Cancer Network web sitehttp://www.nccn.org/ Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.