Paget's Disease

Paget's Disease is an intra-epidennal and intra-ductal epithelioma affecting the areola and nipple of the female breast; it may also be seen in males, and on other sites of the body like the genitalia and umbilicus.

It is seen typically as a well-defined patch of erythema and scaling or oozing with gradual induration, infiltration and retraction of the nipple. In the course of time, a palpable carcinoma of the breast becomes discernible.

Histology: It is characterized by acanthosis, a disorganized epidermis inclusive of the basal cell layer, the presence of typical, large pale-staining Paget's cells in the epidermis, the walls of the hair follicles and the lactiferous ducts.

Diagnosis of Paget's Disease

It is based upon the demonstration of a sharply-defined, indurated lesion around the nipple which may be retracted. Paget's disease usually affects one nipple. The differential diagnosis is made mainly from contact or infective eczematoid dermatitis of the nipples. Eczema occurs at any age, is bilateral, there is oozing and crusting accompanied by itching, edges are ill-defined. Further, it has no induration and nipples are not retracted. History is chronic with periods of complete remission.

Prognosis of Paget's Disease

It depends upon the stage at which the diagnosis is made. It is similar to cancer of the breast.

Treatment of Paget's Disease

It consists of radical surgery of the breast and the lymph glands with or without radiotherapy.