Paget's disease of the breast: diagnosis and management

Hudson-Phillips, Sarah; Cox, Kofi; Patel, Puja; Sarakbi, Wail Al

doi:10.12968/hmed.2022.0439

Cited by 7 publications

(3 citation statements)

References 34 publications

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“…Breast surgeons are currently improving their techniques, and as time goes by, they have become more skilled in performing these techniques, which has led to the expansion of indications for OBS ( 42 ). Although the tumor board discusses case management, the surgery board discusses the surgical indications ( 43 , 44 ). Our group is composed of six surgeons with experience in performing OBS.…”

Section: Discussionmentioning

confidence: 99%

Oncoplastic surgery for Paget’s disease of the breast

Pelorca,

de Oliveira-Junior,

da Costa Vieira

2023

Front. Oncol.

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IntroductionPaget’s disease of the breast (PDB) is a rare nipple entity associated with multifocality. Due to its location, resection of the entire nipple-areolar complex is necessary. Historically central quadrantectomy and mastectomy have the surgical treatments of choice. The feasibility of oncoplastic breast surgery (OBS) for PDB is unknown.MethodsThis was a retrospective study performed in a Brazilian oncological hospital. We evaluated the factors related to the performance of OBS in PDB. In addition, the impact of OBS on local recurrence and survival was analysed. Comparisons were made between groups using the chi-square test, Mann−Whitney U test, and Kaplan–Meier method. To assess the impact factor of the variables on the performance of OBS, logistic regression was performed.ResultsEighty-five patients were evaluated. OBS was performed in 69.4% (n=59), and of these, 16 (27.2%) were symmetrized with contralateral surgery. Mastectomy without reconstruction was performed in 28.3% of the patients. The primary procedure performed was mastectomy with reconstruction (n=38; 44.7%), and the preferential technique for immediate reconstruction was skin-sparing mastectomy with prosthesis; for late reconstruction, the preferred technique was using the latissimus dorsi. Breast conserving-surgery was performed in 27.0% (n=23), primarily using the plug-flap technique (OBS). Age was associated with the use of OBS; as patients aged 40-49 exhibited a higher rate of OBS (p = 0.002; odds ratio 3.22). OBS did not influence local recurrence (p=1.000), overall survival (p=0.185), or cancer-specific survival (p=0.418).ConclusionOBS improves options related to surgical treatment in PDB without affecting local recurrence or survival rates.

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Section: Discussionmentioning

confidence: 99%

Oncoplastic surgery for Paget’s disease of the breast

Pelorca,

de Oliveira-Junior,

da Costa Vieira

2023

Front. Oncol.

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“…Accurate assessment and appropriate management of patients with MPD require a multidisciplinary discussion conducted by an expert team [53].…”

Section: Notes Of Therapymentioning

confidence: 99%

A Pictorial Exploration of Mammary Paget Disease: Insights and Perspectives

Mariano,

Nicosia,

Pupo

et al. 2023

Cancers

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Mammary Paget disease (MPD) is a rare condition primarily affecting adult women, characterized by unilateral skin changes in the nipple–areolar complex (NAC) and frequently associated with underlying breast carcinoma. Histologically, MPD is identified by large intraepidermal epithelial cells (Paget cells) with distinct characteristics. Immunohistochemical profiles aid in distinguishing MPD from other skin conditions. Clinical evaluation and imaging techniques, including magnetic resonance imaging (MRI), are recommended if MPD is suspected, although definitive diagnosis always requires histological examination. This review delves into the historical context, epidemiology, pathogenesis, clinical manifestations, and diagnosis of MPD, emphasizing the need for early detection. The classification of MPD based on pathogenesis is explored, shedding light on its varied presentations. Treatment options, including mastectomy and breast-conserving surgery, are discussed with clear guidelines for different scenarios. Adjuvant therapies are considered, particularly in cases with underlying breast cancer. Prognostic factors are outlined, underlining the importance of early intervention. Looking to the future, emerging techniques, like liquid biopsy, new immunohistochemical and molecular markers, and artificial intelligence-based image analysis, hold the potential to transform MPD diagnosis and treatment. These innovations offer hope for early detection and improved patient care, though validation through large-scale clinical trials is needed.

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“…The main clinical manifestations are breast mass [3], abnormal nipple areola, nipple discharge, axillary lymph node enlargement, etc. [4,5]. Currently, the cause of breast cancer cannot be clearly determined, but researchers believe that the occurrence of breast cancer [6] is related to age, family history, long-term excessive use of exogenous estrogen and other factors [7,8].…”

Section: Introductionmentioning

confidence: 99%

Breast cancer detection via wavelet energy and feed-forward neural network trained by genetic algorithm

Wang

2023

EAI Endorsed Trans AI Robotics

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Enhancing the precision of breast cancer detection is the primary objective of this investigation, given its status as the most prevalent cancer among women worldwide. Timely identification of breast cancer can significantly improve the likelihood of successful diagnosis. To achieve this, we propose a innovative way that combines wavelet energy and a feedforward neural network. Our method employs the genetic algorithm and undergoes 20 iterations of 10-fold cross-validation for robustness. Via utilizing wavelet energy as a feature extractor and a feedforward neural network as the classifier, our method outperforms three alternative algorithms.

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Paget's disease of the breast: diagnosis and management

Cited by 7 publications

References 34 publications

Oncoplastic surgery for Paget’s disease of the breast

Oncoplastic surgery for Paget’s disease of the breast

A Pictorial Exploration of Mammary Paget Disease: Insights and Perspectives

Breast cancer detection via wavelet energy and feed-forward neural network trained by genetic algorithm

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