Paget’s disease in the era of sentinel lymph node biopsy

Laronga, Christine; Hasson, Danielle M.; Hoover, Susan; Cox, John M.; Cantor, Alan; Cox, Charles E.; Carter, W. Bradford

doi:10.1016/j.amjsurg.2006.06.023

Cited by 38 publications

(16 citation statements)

References 3 publications

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“…Similarly, these studies supported the use of BCS with radiotherapy as a feasible alternative for patients with PD-IDC. Although SLNB may still be considered a controversial treatment in patients with PD, SLNB has become a common approach in patients with breast cancer and appears to be a feasible treatment option1516. When IDC has been identified and a mastectomy has been completed, SLNB should still be routinely employed in axillary node negative DCIS patients1718.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment in Paget’s disease with invasive ductal carcinoma: an observational study based on SEER

Ding

et al. 2017

Sci Rep

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The aim is to analyse the clinical presentation, treatment and outcomes in patients with Paget’s disease with invasive ductal carcinoma (PD-IDC), with special emphasis on the role of surgical treatment. Using data obtained by the Surveillance, Epidemiology, and End Results (SEER) program from 2010–2013, we investigated the differences in characteristics, overall survival (OS), and breast cancer-specific mortality (BCSM) between patients with PD-IDC and those with invasive ductal carcinoma (IDC). Compared with IDC group, patients with PD-IDC had a better prognosis and lower mortality in adjusted analyses. In the multivariate analysis of cases with PD-IDC, history of ALND was significantly associated with OS while Her2 status were associated with BCSM. Further, subgroup analysis demonstrated no difference between surgical treatment subgroups for either OS or BCSM. The results demonstrated that PD-IDC appears to alter the association between prognosis and Her2 status. Meanwhile, breast-conserving surgery with radiotherapy may be a feasible treatment alternative and sentinel lymph node biopsy should be considered as an appropriate treatment for patients with PD-IDC.

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Section: Discussionmentioning

confidence: 99%

Surgical treatment in Paget’s disease with invasive ductal carcinoma: an observational study based on SEER

Ding

et al. 2017

Sci Rep

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“…Therefore, breast‐conserving therapy is a feasible treatment option in selected patients . In addition, surgical axillary lymph node staging is a standard treatment for PD‐IDC, but its use is controversial in PD‐DCIS . Based on our finding that some PD‐DCIS patients were lymph node positive, the consideration of surgical axillary staging is necessary.…”

Section: Discussionmentioning

confidence: 99%

“…23 In addition, surgical axillary lymph node staging is a standard treatment for PD-IDC, but its use is controversial in PD-DCIS. 14,24 Based on our finding that some PD-DCIS patients were lymph node positive, the consideration of surgical axillary staging is necessary. Regarding systemic adjuvant therapy, there have been few investigations and studies in PD, and the current consensus is to refer to the approach for the corresponding breast cancer without PD.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of breast cancer with or without concomitant Paget disease: An analysis of the SEER database

Chen

Yuan

et al. 2019

Cancer Medicine

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Background Most mammary Paget disease (MPD) is associated with underlying in situ or invasive breast cancer. The objective of this study was to compare the clinicopathological characteristics and survival outcomes between breast cancer with Paget disease (PD) and breast cancer alone. Methods From the Surveillance, Epidemiology, and End Results (SEER) database, 2000‐2015, of the US National Cancer Institute, we identified 1569 women who had PD with invasive ductal carcinoma (PD‐IDC) and 1489 women who had PD with ductal carcinoma in situ (PD‐DCIS). Independent demographic and clinicopathological variables as well as survival outcomes of these patients were compared to patients with the corresponding breast cancer without concomitant PD. Results PD‐IDC and PD‐DCIS both had worse survival outcomes and poorer tumor characteristics than the corresponding disease without PD. Contrary to in the breast cancer alone groups, in the breast cancer with PD groups, the HR status ( P = 0.182 in PD‐IDC and P = 0.371 in PD‐DCIS), HER2 status ( P = 0.788 in PD‐IDC and P = 0.643 in PD‐DCIS), and combined molecular subtype ( P = 0.196 in PD‐IDC and P = 0.853 in PD‐DCIS) were not found to affect disease prognosis. After matching tumor characteristics and treatment approaches, PD‐IDC as well as PD‐DCIS exhibited no significant difference in disease prognosis with corresponding IDC and DCIS. Finally, by comparative analysis, a kind of PD‐DCIS (ICD‐O‐3 code 8543/3) showed many invasive behaviors (31.8% of 8543/3 patients had stage I‐III cancer) and was associated with worse survival outcomes than the other type of PD‐DCIS. Conclusions Breast cancer with concomitant PD was associated with more aggressive tumor characteristics and worse survival outcomes. The HR status, HER2 status, and combined molecular subtype could not affect the prognosis of breast cancer with PD. Moreover, a portion of the PD‐DCIS cases were invasive breast cancer cases that required special treatment.

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“…The authors concluded that SNB should be considered in all patients with PDN, regardless of whether associated clinical or radiographic fi ndings are present [20]. Laronga et al reviewed 54 patients with PDN, of whom 36 had SNB, and concluded that PDN should be treated similarly to other breast cancers; SNB should be performed in order to evaluate the axilla when invasive disease is identified or a mastectomy is planned owing to the extent of DCIS [21].…”

Section: Treatmentmentioning

confidence: 96%

Paget's Disease of the Nipple

Seetharam

Fentiman

2009

Womens Health (Lond Engl)

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Paget's disease of the nipple is an unusual epidermal presentation of underlying breast cancer. It presents as eczematous change or erythematous ulceration, but may also be an incidental histological finding in a mastectomy specimen. Approximately half of the underlying cancers are invasive, the remainder being ductal carcinoma in situ, and only rarely is there no associated malignancy. Routine clinical and mammographic assessment may significantly underestimate the extent of disease, but MRI may increase the sensitivity in detecting occult malignancy. Mastectomy maximizes local control; however, selected cases can be treated by nipple conisation with radiotherapy. Sentinel node biopsy is the standard of care for axillary staging in the clinically and ultrasonically node-negative case. Almost all invasive cases overexpress human EGF receptor-2 and, therefore, are likely to benefit from adjuvant chemotherapy and herceptin.

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Paget’s disease in the era of sentinel lymph node biopsy

Cited by 38 publications

References 3 publications

Surgical treatment in Paget’s disease with invasive ductal carcinoma: an observational study based on SEER

Surgical treatment in Paget’s disease with invasive ductal carcinoma: an observational study based on SEER

Comparative study of breast cancer with or without concomitant Paget disease: An analysis of the SEER database

Paget's Disease of the Nipple

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