Paget's disease of the breast: There is a role for breast-conserving therapy

Kazumi Kawase, Dominick J. DiMaio, Susan L. Tucker, Thomas A. Buchholz, Merrick I. Ross, Barry W. Feig, Henry M. Kuerer, Funda Meric-Bernstam, Gildy Babiera, Frederick C. Ames, S. Eva Singletary, Kelly K. Hunt

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

Background: The optimal surgical management of Paget's disease of the breast remains to be defined. Mastectomy has been the standard of care, but several institutions have recently advocated breast-conserving surgery, particularly for patients with minimal disease. In an effort to develop rational treatment guidelines, we examined our institutional experience with Paget's disease of the breast. Methods: Patients with Paget's disease of the breast who had surgical therapy at our institution between 1949 and 1993 were reviewed. In addition to patient and tumor characteristics, charts were reviewed for treatment modalities, locoregional recurrence patterns, and survival. Subgroups were compared for differences in survival in both univariate and multivariate analyses. Results: A total of 104 patients met the study criteria. The most common presenting symptoms were nipple discharge and eczematous changes of the nipple/areola complex. Ninety-seven patients (93.2%) had an underlying invasive or noninvasive cancer associated with Paget's disease. Ninety-two patients (88.5%) underwent mastectomy, and 12 (11.5%) had a breast-conserving procedure. On univariate analysis, patients with age <60 years at diagnosis, stage II disease, positive lymph nodes, invasive disease, or a palpable mass had significantly lower 10-year disease-specific and recurrence-free survival. There were four locoregional recurrences (three after mastectomy and one after breast conservation). There were no significant differences in overall, disease-specific, or recurrence-free survival according to the type of surgery. Conclusions: Paget's disease of the breast is almost always associated with an underlying breast cancer. Breast-conserving approaches result in local control and survival rates similar to those achieved with mastectomy.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalAnnals of Surgical Oncology
Volume12
Issue number5
DOIs
StatePublished - May 1 2005

Fingerprint

Mammary Paget's Disease
Breast
Mastectomy
Recurrence
Survival
Nipples
Therapeutics
Segmental Mastectomy
Standard of Care
Neoplasms
Multivariate Analysis
Survival Rate
Lymph Nodes
Guidelines
Breast Neoplasms

Keywords

  • Breast cancer
  • Breast conservation
  • Paget's disease
  • Survival

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Kawase, K., DiMaio, D. J., Tucker, S. L., Buchholz, T. A., Ross, M. I., Feig, B. W., ... Hunt, K. K. (2005). Paget's disease of the breast: There is a role for breast-conserving therapy. Annals of Surgical Oncology, 12(5), 1-7. https://doi.org/10.1245/ASO.2005.05.026

Paget's disease of the breast : There is a role for breast-conserving therapy. / Kawase, Kazumi; DiMaio, Dominick J.; Tucker, Susan L.; Buchholz, Thomas A.; Ross, Merrick I.; Feig, Barry W.; Kuerer, Henry M.; Meric-Bernstam, Funda; Babiera, Gildy; Ames, Frederick C.; Singletary, S. Eva; Hunt, Kelly K.

In: Annals of Surgical Oncology, Vol. 12, No. 5, 01.05.2005, p. 1-7.

Research output: Contribution to journalArticle

Kawase, K, DiMaio, DJ, Tucker, SL, Buchholz, TA, Ross, MI, Feig, BW, Kuerer, HM, Meric-Bernstam, F, Babiera, G, Ames, FC, Singletary, SE & Hunt, KK 2005, 'Paget's disease of the breast: There is a role for breast-conserving therapy', Annals of Surgical Oncology, vol. 12, no. 5, pp. 1-7. https://doi.org/10.1245/ASO.2005.05.026
Kawase, Kazumi ; DiMaio, Dominick J. ; Tucker, Susan L. ; Buchholz, Thomas A. ; Ross, Merrick I. ; Feig, Barry W. ; Kuerer, Henry M. ; Meric-Bernstam, Funda ; Babiera, Gildy ; Ames, Frederick C. ; Singletary, S. Eva ; Hunt, Kelly K. / Paget's disease of the breast : There is a role for breast-conserving therapy. In: Annals of Surgical Oncology. 2005 ; Vol. 12, No. 5. pp. 1-7.
@article{8907a422963c46c2aa50968d8f015e3c,
title = "Paget's disease of the breast: There is a role for breast-conserving therapy",
abstract = "Background: The optimal surgical management of Paget's disease of the breast remains to be defined. Mastectomy has been the standard of care, but several institutions have recently advocated breast-conserving surgery, particularly for patients with minimal disease. In an effort to develop rational treatment guidelines, we examined our institutional experience with Paget's disease of the breast. Methods: Patients with Paget's disease of the breast who had surgical therapy at our institution between 1949 and 1993 were reviewed. In addition to patient and tumor characteristics, charts were reviewed for treatment modalities, locoregional recurrence patterns, and survival. Subgroups were compared for differences in survival in both univariate and multivariate analyses. Results: A total of 104 patients met the study criteria. The most common presenting symptoms were nipple discharge and eczematous changes of the nipple/areola complex. Ninety-seven patients (93.2{\%}) had an underlying invasive or noninvasive cancer associated with Paget's disease. Ninety-two patients (88.5{\%}) underwent mastectomy, and 12 (11.5{\%}) had a breast-conserving procedure. On univariate analysis, patients with age <60 years at diagnosis, stage II disease, positive lymph nodes, invasive disease, or a palpable mass had significantly lower 10-year disease-specific and recurrence-free survival. There were four locoregional recurrences (three after mastectomy and one after breast conservation). There were no significant differences in overall, disease-specific, or recurrence-free survival according to the type of surgery. Conclusions: Paget's disease of the breast is almost always associated with an underlying breast cancer. Breast-conserving approaches result in local control and survival rates similar to those achieved with mastectomy.",
keywords = "Breast cancer, Breast conservation, Paget's disease, Survival",
author = "Kazumi Kawase and DiMaio, {Dominick J.} and Tucker, {Susan L.} and Buchholz, {Thomas A.} and Ross, {Merrick I.} and Feig, {Barry W.} and Kuerer, {Henry M.} and Funda Meric-Bernstam and Gildy Babiera and Ames, {Frederick C.} and Singletary, {S. Eva} and Hunt, {Kelly K.}",
year = "2005",
month = "5",
day = "1",
doi = "10.1245/ASO.2005.05.026",
language = "English (US)",
volume = "12",
pages = "1--7",
journal = "Annals of Surgical Oncology",
issn = "1068-9265",
publisher = "Springer New York",
number = "5",

}

TY - JOUR

T1 - Paget's disease of the breast

T2 - There is a role for breast-conserving therapy

AU - Kawase, Kazumi

AU - DiMaio, Dominick J.

AU - Tucker, Susan L.

AU - Buchholz, Thomas A.

AU - Ross, Merrick I.

AU - Feig, Barry W.

AU - Kuerer, Henry M.

AU - Meric-Bernstam, Funda

AU - Babiera, Gildy

AU - Ames, Frederick C.

AU - Singletary, S. Eva

AU - Hunt, Kelly K.

PY - 2005/5/1

Y1 - 2005/5/1

N2 - Background: The optimal surgical management of Paget's disease of the breast remains to be defined. Mastectomy has been the standard of care, but several institutions have recently advocated breast-conserving surgery, particularly for patients with minimal disease. In an effort to develop rational treatment guidelines, we examined our institutional experience with Paget's disease of the breast. Methods: Patients with Paget's disease of the breast who had surgical therapy at our institution between 1949 and 1993 were reviewed. In addition to patient and tumor characteristics, charts were reviewed for treatment modalities, locoregional recurrence patterns, and survival. Subgroups were compared for differences in survival in both univariate and multivariate analyses. Results: A total of 104 patients met the study criteria. The most common presenting symptoms were nipple discharge and eczematous changes of the nipple/areola complex. Ninety-seven patients (93.2%) had an underlying invasive or noninvasive cancer associated with Paget's disease. Ninety-two patients (88.5%) underwent mastectomy, and 12 (11.5%) had a breast-conserving procedure. On univariate analysis, patients with age <60 years at diagnosis, stage II disease, positive lymph nodes, invasive disease, or a palpable mass had significantly lower 10-year disease-specific and recurrence-free survival. There were four locoregional recurrences (three after mastectomy and one after breast conservation). There were no significant differences in overall, disease-specific, or recurrence-free survival according to the type of surgery. Conclusions: Paget's disease of the breast is almost always associated with an underlying breast cancer. Breast-conserving approaches result in local control and survival rates similar to those achieved with mastectomy.

AB - Background: The optimal surgical management of Paget's disease of the breast remains to be defined. Mastectomy has been the standard of care, but several institutions have recently advocated breast-conserving surgery, particularly for patients with minimal disease. In an effort to develop rational treatment guidelines, we examined our institutional experience with Paget's disease of the breast. Methods: Patients with Paget's disease of the breast who had surgical therapy at our institution between 1949 and 1993 were reviewed. In addition to patient and tumor characteristics, charts were reviewed for treatment modalities, locoregional recurrence patterns, and survival. Subgroups were compared for differences in survival in both univariate and multivariate analyses. Results: A total of 104 patients met the study criteria. The most common presenting symptoms were nipple discharge and eczematous changes of the nipple/areola complex. Ninety-seven patients (93.2%) had an underlying invasive or noninvasive cancer associated with Paget's disease. Ninety-two patients (88.5%) underwent mastectomy, and 12 (11.5%) had a breast-conserving procedure. On univariate analysis, patients with age <60 years at diagnosis, stage II disease, positive lymph nodes, invasive disease, or a palpable mass had significantly lower 10-year disease-specific and recurrence-free survival. There were four locoregional recurrences (three after mastectomy and one after breast conservation). There were no significant differences in overall, disease-specific, or recurrence-free survival according to the type of surgery. Conclusions: Paget's disease of the breast is almost always associated with an underlying breast cancer. Breast-conserving approaches result in local control and survival rates similar to those achieved with mastectomy.

KW - Breast cancer

KW - Breast conservation

KW - Paget's disease

KW - Survival

UR - http://www.scopus.com/inward/record.url?scp=21144440477&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=21144440477&partnerID=8YFLogxK

U2 - 10.1245/ASO.2005.05.026

DO - 10.1245/ASO.2005.05.026

M3 - Article

C2 - 15915373

AN - SCOPUS:21144440477

VL - 12

SP - 1

EP - 7

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

IS - 5

ER -