Materiały źródłowe

• #1

  https://www.nhs.uk/conditions/pagets-disease-nipple/treatment/

  Paget’s disease of the nipple is usually associated with breast cancer. […] It’s treated by removing the cancerous part of the breast, or sometimes the entire breast using a procedure called a mastectomy. […] If you’re diagnosed with Paget’s disease of the nipple, surgery is often the first type of treatment you’ll receive. […] The 2 main types of surgery are: mastectomy surgery to remove the whole breast, which can be followed by reconstructive surgery to recreate the removed breast and breast-conserving surgery where only the cancerous lump (tumour) and a little surrounding breast tissue are removed. […] During a mastectomy, all of your breast tissue, including your nipple, will be removed. […] Breast-conserving surgery aims to save as much of your breast as possible while removing the cancer and a small amount of healthy tissue.

• #2 Paget’s disease of the breast | Breast Cancer Now

  https://breastcancernow.org/about-breast-cancer/diagnosis/types-of-breast-cancer/pagets-disease-of-the-breast/

  Treatment aims to remove the area of Pagets disease from your breast and reduce the risk of it coming back or spreading to other parts of the body. […] Surgery is usually the first treatment for Pagets disease of the breast. Its often the only treatment youll need if you have Pagets disease without DCIS or invasive breast cancer. […] If youve been diagnosed with Pagets disease alone, youre most likely to be offered surgery to remove your nipple and areola. This is known as a central excision. […] You may be offered other types of surgery if you have also been diagnosed with DCIS or invasive breast cancer, such as breast-conserving surgery or a mastectomy. […] Depending on the features of your Pagets disease, you may also be offered radiotherapy after your surgery. Radiotherapy uses high-energy x-rays to destroy cancer cells. Its used to reduce the risk of the cancer coming back in the same breast.

• #2 Paget’s disease of the breast – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pagets-disease-of-the-breast/diagnosis-treatment/drc-20351084

  If you have Paget’s disease of the breast, you will likely need surgery. The type of surgery depends on the condition of the skin around your nipple and how advanced the underlying cancer is. […] Surgical options include: […] A mastectomy is an operation to remove all of your breast tissue. Most mastectomy procedures remove all of the breast tissue the lobules, ducts, fatty tissue and some skin, including the nipple and areola (total or simple mastectomy). […] During a lumpectomy, which may be referred to as breast-conserving surgery or wide local excision, the surgeon removes the cancer and a small margin of surrounding healthy tissue. If you and your doctor choose this option, you will also receive radiation therapy afterward. […] After your operation, your doctor may recommend additional treatment (adjuvant therapy) with anti-cancer drugs (chemotherapy), radiation therapy or hormone therapy to prevent a recurrence of breast cancer. […] Your specific treatment will depend on the extent of the cancer and whether your cancer tests positive for certain characteristics, such as having estrogen or progesterone receptors.

• #3 Paget’s Disease of the Breast: Stages, Symptoms & Prognosis

  https://my.clevelandclinic.org/health/diseases/17913-pagets-disease-of-the-breast

  Paget’s disease of the breast is a rare type of breast cancer that develops in the skin of the nipple. The primary treatment is surgery. […] Treatment involves surgery and sometimes additional cancer therapies. […] Any cancer in your breast will need to be surgically removed, but how much tissue is removed will depend on your condition. If you only have Paget’s disease of the breast, and no other tumors, you may have more minimal, breast-conserving surgery. […] Depending on how extensive the cancer is, your surgeon may recommend a mastectomy as well. You may have breast reconstruction surgery afterward if you choose. […] After surgery, you’ll likely have additional, complementary treatments to prevent cancer from recurring. Adjuvant therapies may include radiation therapy, chemotherapy, hormone therapy, and immunotherapy.

• #4

  https://www.nhs.uk/conditions/pagets-disease-nipple/

  Surgery is the main treatment for Paget’s disease of the nipple. Depending on whether the cancer has spread, surgery will either involve removing the whole breast (a mastectomy), or the nipple and areola with the breast tissue underneath them (a central excision). […] If the whole of your breast is removed, breast reconstruction surgery can be used to create a breast shape to match your remaining breast. […] You may also need further treatment if you have invasive breast cancer. This may be a combination of: chemotherapy where powerful medicine is used to destroy cancerous cells, radiotherapy where controlled doses of high-energy radiation are used to destroy cancerous cells, targeted or hormone therapy which lowers the risk of cancer returning in the same breast (and affecting the other breast), and it lowers the risk of cancerous cells spreading elsewhere in the body. […] If Paget’s disease is detected and treated in its early stages, there’s a good chance of a full recovery.

• #5 Paget Disease of the Breast | Details, Diagnosis and Signs | American Cancer Society

  https://www.cancer.org/cancer/types/breast-cancer/about/types-of-breast-cancer/paget-disease-of-the-nipple.html

  Paget disease can be treated by removing the entire breast (mastectomy) or breast-conserving surgery (BCS) followed by whole-breast radiation therapy. If BCS is done, the entire nipple and areola area also needs to be removed. […] If the cancer has spread within the breast tissue (is invasive), the outlook is not as good, and the cancer will be staged and treated like any other invasive ductal carcinoma.

• #6 Breast-conserving therapy for Paget disease of the nipple: a prospective European Organization for Research and Treatment of Cancer study of 61 patients – PubMed

  https://pubmed.ncbi.nlm.nih.gov/11169928/

  The purpose of the current study was to assess the outcome of breast-conserving therapy by means of a cone excision and radiotherapy in patients with Paget disease of the nipple without associated invasive breast carcinoma. […] Treatment was comprised of a complete excision of the nipple-areolar complex including the underlying breast tissue with tumor free margins, followed by external irradiation to the whole breast (50 gray in 25 fractions). […] Breast-conserving therapy is a feasible alternative for patients with Paget disease and a limited extent of underlying DCIS. To achieve good local control, treatment should be comprised of a complete excision of the nipple-areolar complex including the underlying disease, followed by irradiation to the whole breast.

• #7 Paget’s disease of the breast | Breast Cancer Now

  https://breastcancernow.org/about-breast-cancer/diagnosis/types-of-breast-cancer/pagets-disease-of-the-breast/

  Treatment aims to remove the area of Pagets disease from your breast and reduce the risk of it coming back or spreading to other parts of the body. […] Surgery is usually the first treatment for Pagets disease of the breast. Its often the only treatment youll need if you have Pagets disease without DCIS or invasive breast cancer. […] If youve been diagnosed with Pagets disease alone, youre most likely to be offered surgery to remove your nipple and areola. This is known as a central excision. […] You may be offered other types of surgery if you have also been diagnosed with DCIS or invasive breast cancer, such as breast-conserving surgery or a mastectomy. […] Depending on the features of your Pagets disease, you may also be offered radiotherapy after your surgery. Radiotherapy uses high-energy x-rays to destroy cancer cells. Its used to reduce the risk of the cancer coming back in the same breast.

• #8 Treatment options for Paget’s disease of the nipple | Cancer Australia

  https://www.canceraustralia.gov.au/cancer-types/breast-cancer/treatment-options/treatment-options-pagets-disease-nipple

  Treatment for Paget’s disease of the nipple will depend on how much of the nipple, areola and breast is involved. […] Where Paget’s disease of the nipple is the only cancer in the breast, treatment usually involves: breast surgery and/or radiotherapy. […] Surgery for Paget’s disease of the nipple usually involves removal the nipple and some surrounding tissue. […] If the nipple is the only area of the breast affected, it’s possible that only the nipple and an area of healthy tissue around it will be removed. This is known as breast conserving surgery. […] Removal of the whole breast (mastectomy) and/or removal of one or more lymph nodes from the armpit may be needed for some patients. […] For women with Paget’s disease of the nipple, radiotherapy is almost always recommended after breast conserving surgery. […] Radiotherapy is sometimes recommended after mastectomy. […] For some women with Paget’s disease of the nipple, radiotherapy may be the only treatment needed after the biopsy used during diagnosis.

• #9 logo–sylvester

  https://umiamihealth.org/en/sylvester-comprehensive-cancer-center/treatments-and-services/breast-cancer/paget%E2%80%99s-disease-of-the-nipple-

  If you have an invasive cancer in addition to Paget’s disease, your doctor may recommend removing your entire breast, called a mastectomy, to make sure all cancer cells are removed. If you decide you want reconstructive surgery to restore your breast, you can do so as part of your initial surgery or wait until later to have surgery. […] In this surgery, your surgeon removes your entire breast, but leaves your underarm lymph nodes intact. […] With a modified radical mastectomy, your surgeon removes the nipple, areola and all of the breast tissue without removing the underlying muscle. […] Doctors use this minor surgery to determine if cancer has spread beyond a primary tumor into your lymphatic system. A sentinel lymph node is the first place cancer cells may move to when they begin to spread.

• #10 Paget Disease of the Breast – NCI

  https://www.cancer.gov/types/breast/paget-breast-fact-sheet

  How is Paget disease of the breast treated? […] For many years, mastectomy, with or without the removal of lymph nodes under the arm on the same side of chest (known as axillary lymph node dissection), was regarded as the standard surgery for Paget disease of the breast (3, 4). […] Studies have shown, however, that breast-conserving surgery that includes removal of the nipple and areola, followed by whole-breast radiation therapy, is a safe option for people with Paget disease of the breast who do not have a palpable lump in their breast and whose mammograms do not reveal a tumor (35). […] People with Paget disease of the breast who have a breast tumor and are having a mastectomy should be offered sentinel lymph node biopsy to see whether the cancer has spread to the axillary lymph nodes.

• #11

  https://www.nhs.uk/conditions/pagets-disease-nipple/treatment/

  After having breast-conserving surgery, it’s likely you’ll need to have radiotherapy to destroy any remaining cancer cells. […] If you have a mastectomy, you may be able to have reconstructive surgery to recreate your breast. […] If you decide not to have breast reconstruction, you can wear a false breast or breast prosthesis, which is available free on the NHS. […] After your surgery, you may need further treatment if you have invasive breast cancer (where the cancerous cells have spread into other tissue in your breast). […] Other types of treatment for breast cancer include: chemotherapy where powerful medicine is used to destroy cancer cells and prevent them dividing and growing, radiotherapy where controlled doses of high-energy radiation, usually X-rays, are used to destroy cancer cells, targeted therapy if your breast cancer is HER2 positive, targeted therapy, usually a medicine called trastuzumab, can be used to treat the cancer by stopping the effects of HER2 and helping your immune system fight off cancer cells, hormone therapy if your breast cancer is hormone-receptor positive, hormone therapy can be used to treat the cancer by lowering the levels of hormones in your body or stopping their effects.

• #12 Breast-conserving therapy for Paget disease of the nipple: a prospective European Organization for Research and Treatment of Cancer study of 61 patients – PubMed

  https://pubmed.ncbi.nlm.nih.gov/11169928/

  The purpose of the current study was to assess the outcome of breast-conserving therapy by means of a cone excision and radiotherapy in patients with Paget disease of the nipple without associated invasive breast carcinoma. […] Treatment was comprised of a complete excision of the nipple-areolar complex including the underlying breast tissue with tumor free margins, followed by external irradiation to the whole breast (50 gray in 25 fractions). […] Breast-conserving therapy is a feasible alternative for patients with Paget disease and a limited extent of underlying DCIS. To achieve good local control, treatment should be comprised of a complete excision of the nipple-areolar complex including the underlying disease, followed by irradiation to the whole breast.

• #13 Breast-conserving therapy for Paget disease of the nipple: a prospective European Organization for Research and Treatment of Cancer study of 61 patients – PubMed

  https://pubmed.ncbi.nlm.nih.gov/11169928/

  The purpose of the current study was to assess the outcome of breast-conserving therapy by means of a cone excision and radiotherapy in patients with Paget disease of the nipple without associated invasive breast carcinoma. […] Treatment was comprised of a complete excision of the nipple-areolar complex including the underlying breast tissue with tumor free margins, followed by external irradiation to the whole breast (50 gray in 25 fractions). […] Breast-conserving therapy is a feasible alternative for patients with Paget disease and a limited extent of underlying DCIS. To achieve good local control, treatment should be comprised of a complete excision of the nipple-areolar complex including the underlying disease, followed by irradiation to the whole breast.

• #14 Treatment options for Paget’s disease of the nipple | Cancer Australia

  https://www.canceraustralia.gov.au/cancer-types/breast-cancer/treatment-options/treatment-options-pagets-disease-nipple

  Treatment for Paget’s disease of the nipple will depend on how much of the nipple, areola and breast is involved. […] Where Paget’s disease of the nipple is the only cancer in the breast, treatment usually involves: breast surgery and/or radiotherapy. […] Surgery for Paget’s disease of the nipple usually involves removal the nipple and some surrounding tissue. […] If the nipple is the only area of the breast affected, it’s possible that only the nipple and an area of healthy tissue around it will be removed. This is known as breast conserving surgery. […] Removal of the whole breast (mastectomy) and/or removal of one or more lymph nodes from the armpit may be needed for some patients. […] For women with Paget’s disease of the nipple, radiotherapy is almost always recommended after breast conserving surgery. […] Radiotherapy is sometimes recommended after mastectomy. […] For some women with Paget’s disease of the nipple, radiotherapy may be the only treatment needed after the biopsy used during diagnosis.

• #15 Treatment options for Paget’s disease of the nipple | Cancer Australia

  https://www.canceraustralia.gov.au/cancer-types/breast-cancer/treatment-options/treatment-options-pagets-disease-nipple

  Treatment for Paget’s disease of the nipple will depend on how much of the nipple, areola and breast is involved. […] Where Paget’s disease of the nipple is the only cancer in the breast, treatment usually involves: breast surgery and/or radiotherapy. […] Surgery for Paget’s disease of the nipple usually involves removal the nipple and some surrounding tissue. […] If the nipple is the only area of the breast affected, it’s possible that only the nipple and an area of healthy tissue around it will be removed. This is known as breast conserving surgery. […] Removal of the whole breast (mastectomy) and/or removal of one or more lymph nodes from the armpit may be needed for some patients. […] For women with Paget’s disease of the nipple, radiotherapy is almost always recommended after breast conserving surgery. […] Radiotherapy is sometimes recommended after mastectomy. […] For some women with Paget’s disease of the nipple, radiotherapy may be the only treatment needed after the biopsy used during diagnosis.

• #16 Practical consensus recommendatons for Paget’s disease in breast cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5909301/

  Use of breast radiation therapy alone for the Paget’s disease of the breast has been reported in limited numbers and with varying results. Current studies suggest that irradiation of the breast tissue to a radical dose may be effective against DCIS. This gives support to the view that selected patients with Paget’s disease of the breast can be treated by radiotherapy as an alternative to radical surgery in selected patients with Paget’s disease confined to the nipple, without clinical or radiological detectable breast tumor.

• #17

  https://www.nhs.uk/conditions/pagets-disease-nipple/treatment/

  After having breast-conserving surgery, it’s likely you’ll need to have radiotherapy to destroy any remaining cancer cells. […] If you have a mastectomy, you may be able to have reconstructive surgery to recreate your breast. […] If you decide not to have breast reconstruction, you can wear a false breast or breast prosthesis, which is available free on the NHS. […] After your surgery, you may need further treatment if you have invasive breast cancer (where the cancerous cells have spread into other tissue in your breast). […] Other types of treatment for breast cancer include: chemotherapy where powerful medicine is used to destroy cancer cells and prevent them dividing and growing, radiotherapy where controlled doses of high-energy radiation, usually X-rays, are used to destroy cancer cells, targeted therapy if your breast cancer is HER2 positive, targeted therapy, usually a medicine called trastuzumab, can be used to treat the cancer by stopping the effects of HER2 and helping your immune system fight off cancer cells, hormone therapy if your breast cancer is hormone-receptor positive, hormone therapy can be used to treat the cancer by lowering the levels of hormones in your body or stopping their effects.

• #18 Paget’s disease of the breast – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pagets-disease-of-the-breast/diagnosis-treatment/drc-20351084

  If you have Paget’s disease of the breast, you will likely need surgery. The type of surgery depends on the condition of the skin around your nipple and how advanced the underlying cancer is. […] Surgical options include: […] A mastectomy is an operation to remove all of your breast tissue. Most mastectomy procedures remove all of the breast tissue the lobules, ducts, fatty tissue and some skin, including the nipple and areola (total or simple mastectomy). […] During a lumpectomy, which may be referred to as breast-conserving surgery or wide local excision, the surgeon removes the cancer and a small margin of surrounding healthy tissue. If you and your doctor choose this option, you will also receive radiation therapy afterward. […] After your operation, your doctor may recommend additional treatment (adjuvant therapy) with anti-cancer drugs (chemotherapy), radiation therapy or hormone therapy to prevent a recurrence of breast cancer. […] Your specific treatment will depend on the extent of the cancer and whether your cancer tests positive for certain characteristics, such as having estrogen or progesterone receptors.

• #19 logo–sylvester

  https://umiamihealth.org/en/sylvester-comprehensive-cancer-center/treatments-and-services/breast-cancer/paget%E2%80%99s-disease-of-the-nipple-

  If you have breast-conserving surgery, rather than a mastectomy, you will also need to have radiation therapy to destroy any cancer cells left behind after surgery. […] Chemotherapy is cancer-fighting medicine that’s administered intravenously or by a pill. Chemotherapy also might be recommended before surgery, called neoadjuvant chemotherapy, to help reduce the size of the tumor and improve surgical results. […] Sylvester offers FDA-cleared cold cap therapy to reduce hair loss during chemotherapy. This therapy works by cooling the scalp during treatment. […] After you have surgery, and possibly radiation therapy, you may need to have one or more additional therapies, such as chemotherapy, targeted therapy or hormone therapy. Since most people with Paget’s disease of the nipple also have invasive breast cancer, your treatment will be based on the type and stage of cancer you have.

• #20

  https://www.advocatehealth.com/health-services/cancer-institute/cancers-we-treat/breast-cancer/pagets-disease-breast

  Treatment for Paget’s disease of the breast typically involves addressing both the disease in the nipple area and any underlying breast cancer. The main treatment options include: […] Surgery: This is a common treatment method. Options include mastectomy, which removes the entire breast, or breast-conserving surgery, like a lumpectomy, which removes the affected tissue while preserving the rest of the breast. […] Radiation therapy: Often used after surgery, radiation therapy helps destroy any remaining cancer cells and reduce the risk of recurrence. […] Chemotherapy: If there is invasive breast cancer, chemotherapy might be necessary to treat cancer throughout the body. […] Hormone therapy: For hormone receptor-positive cancers, hormone therapy can help by blocking the hormones that fuel cancer growth.

• #21 logo–sylvester

  https://umiamihealth.org/en/sylvester-comprehensive-cancer-center/treatments-and-services/breast-cancer/paget%E2%80%99s-disease-of-the-nipple-

  If you have breast-conserving surgery, rather than a mastectomy, you will also need to have radiation therapy to destroy any cancer cells left behind after surgery. […] Chemotherapy is cancer-fighting medicine that’s administered intravenously or by a pill. Chemotherapy also might be recommended before surgery, called neoadjuvant chemotherapy, to help reduce the size of the tumor and improve surgical results. […] Sylvester offers FDA-cleared cold cap therapy to reduce hair loss during chemotherapy. This therapy works by cooling the scalp during treatment. […] After you have surgery, and possibly radiation therapy, you may need to have one or more additional therapies, such as chemotherapy, targeted therapy or hormone therapy. Since most people with Paget’s disease of the nipple also have invasive breast cancer, your treatment will be based on the type and stage of cancer you have.

• #22 Paget’s disease of the breast | Breast Cancer Now

  https://breastcancernow.org/about-breast-cancer/diagnosis/types-of-breast-cancer/pagets-disease-of-the-breast/

  If you also have DCIS or invasive breast cancer, you may be offered other treatments such as chemotherapy, targeted therapy, hormone (endocrine) therapy, or bisphosphonates. […] Treatments given after surgery are called adjuvant treatments. […] If you have invasive breast cancer in addition to Pagets disease, you may be given some treatments before surgery. This is known as neo-adjuvant or primary treatment.

• #23

  https://www.nhs.uk/conditions/pagets-disease-nipple/treatment/

  After having breast-conserving surgery, it’s likely you’ll need to have radiotherapy to destroy any remaining cancer cells. […] If you have a mastectomy, you may be able to have reconstructive surgery to recreate your breast. […] If you decide not to have breast reconstruction, you can wear a false breast or breast prosthesis, which is available free on the NHS. […] After your surgery, you may need further treatment if you have invasive breast cancer (where the cancerous cells have spread into other tissue in your breast). […] Other types of treatment for breast cancer include: chemotherapy where powerful medicine is used to destroy cancer cells and prevent them dividing and growing, radiotherapy where controlled doses of high-energy radiation, usually X-rays, are used to destroy cancer cells, targeted therapy if your breast cancer is HER2 positive, targeted therapy, usually a medicine called trastuzumab, can be used to treat the cancer by stopping the effects of HER2 and helping your immune system fight off cancer cells, hormone therapy if your breast cancer is hormone-receptor positive, hormone therapy can be used to treat the cancer by lowering the levels of hormones in your body or stopping their effects.

• #24 Mammary Paget disease. Paget disease of the nipple

  https://dermnetnz.org/topics/mammary-paget-disease

  The usual treatment of mammary Paget disease is surgical excision. Although mastectomy was routine, especially in males, consideration is now given to breast-conserving surgery (removing the nipple, areola, and underlying breast tissue with a margin of healthy tissue). Sentinel lymph node biopsy assesses node involvement. Axillary lymph node dissection may be required if the breast cancer has spread to lymph nodes. […] Further treatment may include: Radiotherapy, if the primary cancer was large or could not be completely excised, or lymph nodes were positive; Tamoxifen, if oestrogen receptor positive; Trastuzumab (Herceptin), if HER2 positive; Chemotherapy, if the breast cancer is rapidly progressive or advanced.

• #25 Diagnosis and Treatment of Paget’s disease of the breast

  https://www.medindia.net/health/conditions/pagets-disease-diagnosis.htm

  After mastectomy the surgeon takes the biopsy of the lymph node and sends it for examination. This determines whether the patient has to undergo additional treatments or Adjuvant therapy. Adjuvant therapy includes chemotherapy, radiotherapy and sometimes a combination of both the therapies and hormonal therapy. This is mainly done to prevent the recurrence of cancer. […] Radiotherapy: It uses high energy X-rays to destroy the cancer cells. In case of patient who have undergone breast conservation surgery the remaining breast tissue should be exposed to high-energy radiation. […] Chemotherapy: Various cytotoxic drugs are used to destroy the cancer cells. […] Hormone therapy: It is mainly used in case of invasive breast cancers. E.g. Tamoxifen and Arimidex. […] Alternative therapy: Sometimes patients with breast cancer are treated using cow or shark cartilage. They are give hydrazine sulfate or laetrile; extracts of mistletoe plant were also injected (Gerson therapy).

• #26

  https://www.nhs.uk/conditions/pagets-disease-nipple/treatment/

  After having breast-conserving surgery, it’s likely you’ll need to have radiotherapy to destroy any remaining cancer cells. […] If you have a mastectomy, you may be able to have reconstructive surgery to recreate your breast. […] If you decide not to have breast reconstruction, you can wear a false breast or breast prosthesis, which is available free on the NHS. […] After your surgery, you may need further treatment if you have invasive breast cancer (where the cancerous cells have spread into other tissue in your breast). […] Other types of treatment for breast cancer include: chemotherapy where powerful medicine is used to destroy cancer cells and prevent them dividing and growing, radiotherapy where controlled doses of high-energy radiation, usually X-rays, are used to destroy cancer cells, targeted therapy if your breast cancer is HER2 positive, targeted therapy, usually a medicine called trastuzumab, can be used to treat the cancer by stopping the effects of HER2 and helping your immune system fight off cancer cells, hormone therapy if your breast cancer is hormone-receptor positive, hormone therapy can be used to treat the cancer by lowering the levels of hormones in your body or stopping their effects.

• #27 Paget Disease of the Breast – NCI

  https://www.cancer.gov/types/breast/paget-breast-fact-sheet

  Depending on the stage and other features of the underlying breast tumor (for example, the presence or absence of lymph node involvement, estrogen and progesterone receptors in the tumor cells, and HER2 protein overexpression in the tumor cells), adjuvant therapy, consisting of chemotherapy and/or hormonal therapy, may also be recommended.

• #28

  https://www.nhs.uk/conditions/pagets-disease-nipple/treatment/

  Paget’s disease of the nipple is usually associated with breast cancer. […] It’s treated by removing the cancerous part of the breast, or sometimes the entire breast using a procedure called a mastectomy. […] If you’re diagnosed with Paget’s disease of the nipple, surgery is often the first type of treatment you’ll receive. […] The 2 main types of surgery are: mastectomy surgery to remove the whole breast, which can be followed by reconstructive surgery to recreate the removed breast and breast-conserving surgery where only the cancerous lump (tumour) and a little surrounding breast tissue are removed. […] During a mastectomy, all of your breast tissue, including your nipple, will be removed. […] Breast-conserving surgery aims to save as much of your breast as possible while removing the cancer and a small amount of healthy tissue.

• #29

  https://www.nhs.uk/conditions/pagets-disease-nipple/

  Surgery is the main treatment for Paget’s disease of the nipple. Depending on whether the cancer has spread, surgery will either involve removing the whole breast (a mastectomy), or the nipple and areola with the breast tissue underneath them (a central excision). […] If the whole of your breast is removed, breast reconstruction surgery can be used to create a breast shape to match your remaining breast. […] You may also need further treatment if you have invasive breast cancer. This may be a combination of: chemotherapy where powerful medicine is used to destroy cancerous cells, radiotherapy where controlled doses of high-energy radiation are used to destroy cancerous cells, targeted or hormone therapy which lowers the risk of cancer returning in the same breast (and affecting the other breast), and it lowers the risk of cancerous cells spreading elsewhere in the body. […] If Paget’s disease is detected and treated in its early stages, there’s a good chance of a full recovery.

• #30 Paget’s disease of the breast | Breast cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/breast-cancer/types/pagets-disease-breast

  The main treatment is surgery. You have surgery to remove just the affected area (breast conserving surgery) or the whole breast (mastectomy). […] For some women, it is possible to remove just the affected area together with a border of healthy tissue. The surgeon usually removes the nipple and areola. You can then have a new nipple made later, usually when you have fully recovered from your treatment. There are different ways to recreate a new nipple, these include: […] After surgery, you then have radiotherapy to the rest of the breast. […] Your surgeon may recommend you have a mastectomy if the Paget’s disease affects a large area. You may also choose to have a mastectomy if surgery to remove the affected area will not leave you with a good breast shape. You may get a better appearance if you have the whole breast removed and then have surgery to make a new breast shape (breast reconstruction). […] You might have more treatment after surgery if you have Pagets disease with invasive breast cancer or DCIS. The treatments you might have include:

• #31 Paget’s Disease of the Breast: Symptoms, Treatment, Survival

  https://www.verywellhealth.com/pagets-disease-of-the-breast-430628

  Paget’s disease of the breast is a rare cancer of the nipple and areola (the darkened skin around the nipple) closely associated with ductal carcinoma in situ (a cancer of milk ducts). […] Treatments, including mastectomy, tend to be effective, with some people living normal life expectancies. […] The treatment of Paget’s disease of the breast varies by the cancer stage, the type of cancer cells you have, and other factors (like the absence or presence of estrogen receptors). […] Surgery is the primary treatment option. This can take one of two forms: […] A lumpectomy is usually followed by radiation therapy to kill any remaining cancer cells. Many people will have nipple reconstruction after lumpectomy and radiation are completed. […] After mastectomy, your oncologist may recommend additional treatments to prevent breast cancer recurrence. These may involve one or a combination of the following: […] Surgery is the standard treatment for Paget’s disease, sometimes accompanied by chemotherapy, radiation, or hormone therapy.

• #32 Effectiveness of photodynamic therapy for mammary and extra-mammary Paget’s disease: a state of the science review | BMC Dermatology | Full Text

  https://bmcdermatol.biomedcentral.com/articles/10.1186/1471-5945-11-13

  Paget’s disease is a rare skin disorder occurring in the breast (mammary) or in the groin, genital, peri-anal and axillary regions (extra-mammary). Typical treatment involves surgical excision, which in the case of extra-mammary Paget’s disease, can lead to significant morbidity. Photodynamic therapy (PDT) which uses a topical or intravenous photosensitizing agent that is activated by a light source to ablate abnormal tissue, offers a minimally invasive alternative. The purpose of this study was to assess the effectiveness of photodynamic therapy in the treatment of Paget’s disease. […] Treatment typically involves surgical excision. However, this can lead to significant morbidity, especially in the case of extra-mammary Paget’s disease, where the lesions are often large. Additionally, the disease primarily affects older populations, not all of whom can tolerate surgery. Thus, given the potential slow progression of the disease, considerable interest in less invasive approaches exists. One such approach is photodynamic therapy (PDT). PDT uses a photosensitizing agent that, when activated by light of a particular wavelength, induces a chemical reaction within the cells, destroying the affected tissue.

• #33

  https://www.ijcmph.com/index.php/ijcmph/article/view/13517

  Pagets disease of the breast, or mammary Pagets disease (MPD), is a rare and often misdiagnosed form of breast cancer, typically presenting as eczematous or ulcerative lesions on the nipple-areola complex. […] Traditionally, surgical excision has been the cornerstone of treatment, with mastectomy serving as the standard approach. However, advances in imaging and surgical techniques have introduced breast-conserving surgery (BCS) and oncoplastic methods as viable alternatives, particularly for cases with localized disease. […] In addition to surgical management, adjuvant therapies, including radiation and systemic treatments, are reviewed to highlight their role in reducing recurrence and enhancing patient survival. Emerging treatments such as cryoablation, photodynamic therapy (PDT), and immunotherapy are discussed for their potential as adjuncts or alternatives to traditional surgery.

• #34 Effectiveness of photodynamic therapy for mammary and extra-mammary Paget’s disease: a state of the science review | BMC Dermatology | Full Text

  https://bmcdermatol.biomedcentral.com/articles/10.1186/1471-5945-11-13

  Paget’s disease is a rare skin disorder occurring in the breast (mammary) or in the groin, genital, peri-anal and axillary regions (extra-mammary). Typical treatment involves surgical excision, which in the case of extra-mammary Paget’s disease, can lead to significant morbidity. Photodynamic therapy (PDT) which uses a topical or intravenous photosensitizing agent that is activated by a light source to ablate abnormal tissue, offers a minimally invasive alternative. The purpose of this study was to assess the effectiveness of photodynamic therapy in the treatment of Paget’s disease. […] Treatment typically involves surgical excision. However, this can lead to significant morbidity, especially in the case of extra-mammary Paget’s disease, where the lesions are often large. Additionally, the disease primarily affects older populations, not all of whom can tolerate surgery. Thus, given the potential slow progression of the disease, considerable interest in less invasive approaches exists. One such approach is photodynamic therapy (PDT). PDT uses a photosensitizing agent that, when activated by light of a particular wavelength, induces a chemical reaction within the cells, destroying the affected tissue.

• #35

  https://www.ijcmph.com/index.php/ijcmph/article/view/13517

  Goh SSN, Syn NLX, Lim CJE, Lee RE, Samuel M, Ng CWQ. Oncologic outcomes after breast-conserving surgery with radiotherapy versus mastectomy in patients with Paget’s disease of the breast: systematic review and meta-analysis. Brit J Surg. 2023;110(11):1451-7. […] Rzaca M, Tarkowski R. Pagets disease of the nipple treated successfully with cryosurgery: A series of cases report. Cryobiology. 2013;67(1):30-3. […] Tarkowski R, Rzaca M. Cryosurgery in the treatment of women with breast cancer-a review. Gland surgery. 2014;3(2):88-93. […] Yanovsky RL, Bartenstein DW, Rogers GS, Isakoff SJ, Chen ST. Photodynamic therapy for solid tumors: A review of the literature. Photodermatol Photoimmunol Photomed. 2019;35(5):295-303. […] Yang J, Chen Y, Zhang X, Ziyan T, Shanshan W, Ning Z et al. Immunotherapy may be more appropriate for ERBB2 low-expressing extramammary paget’s disease patients: a prognosis analysis and exploration of targeted therapy and immunotherapy of extramammary paget’s disease patients. Cancer Immunol Immunother. 2024;73(12):252.

• #36

  https://www.ijcmph.com/index.php/ijcmph/article/view/13517

  Goh SSN, Syn NLX, Lim CJE, Lee RE, Samuel M, Ng CWQ. Oncologic outcomes after breast-conserving surgery with radiotherapy versus mastectomy in patients with Paget’s disease of the breast: systematic review and meta-analysis. Brit J Surg. 2023;110(11):1451-7. […] Rzaca M, Tarkowski R. Pagets disease of the nipple treated successfully with cryosurgery: A series of cases report. Cryobiology. 2013;67(1):30-3. […] Tarkowski R, Rzaca M. Cryosurgery in the treatment of women with breast cancer-a review. Gland surgery. 2014;3(2):88-93. […] Yanovsky RL, Bartenstein DW, Rogers GS, Isakoff SJ, Chen ST. Photodynamic therapy for solid tumors: A review of the literature. Photodermatol Photoimmunol Photomed. 2019;35(5):295-303. […] Yang J, Chen Y, Zhang X, Ziyan T, Shanshan W, Ning Z et al. Immunotherapy may be more appropriate for ERBB2 low-expressing extramammary paget’s disease patients: a prognosis analysis and exploration of targeted therapy and immunotherapy of extramammary paget’s disease patients. Cancer Immunol Immunother. 2024;73(12):252.

• #37

  https://www.ijcmph.com/index.php/ijcmph/article/view/13517

  Goh SSN, Syn NLX, Lim CJE, Lee RE, Samuel M, Ng CWQ. Oncologic outcomes after breast-conserving surgery with radiotherapy versus mastectomy in patients with Paget’s disease of the breast: systematic review and meta-analysis. Brit J Surg. 2023;110(11):1451-7. […] Rzaca M, Tarkowski R. Pagets disease of the nipple treated successfully with cryosurgery: A series of cases report. Cryobiology. 2013;67(1):30-3. […] Tarkowski R, Rzaca M. Cryosurgery in the treatment of women with breast cancer-a review. Gland surgery. 2014;3(2):88-93. […] Yanovsky RL, Bartenstein DW, Rogers GS, Isakoff SJ, Chen ST. Photodynamic therapy for solid tumors: A review of the literature. Photodermatol Photoimmunol Photomed. 2019;35(5):295-303. […] Yang J, Chen Y, Zhang X, Ziyan T, Shanshan W, Ning Z et al. Immunotherapy may be more appropriate for ERBB2 low-expressing extramammary paget’s disease patients: a prognosis analysis and exploration of targeted therapy and immunotherapy of extramammary paget’s disease patients. Cancer Immunol Immunother. 2024;73(12):252.

• #38 Paget’s disease of the breast – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pagets-disease-of-the-breast/diagnosis-treatment/drc-20351084

  If you have Paget’s disease of the breast, you will likely need surgery. The type of surgery depends on the condition of the skin around your nipple and how advanced the underlying cancer is. […] Surgical options include: […] A mastectomy is an operation to remove all of your breast tissue. Most mastectomy procedures remove all of the breast tissue the lobules, ducts, fatty tissue and some skin, including the nipple and areola (total or simple mastectomy). […] During a lumpectomy, which may be referred to as breast-conserving surgery or wide local excision, the surgeon removes the cancer and a small margin of surrounding healthy tissue. If you and your doctor choose this option, you will also receive radiation therapy afterward. […] After your operation, your doctor may recommend additional treatment (adjuvant therapy) with anti-cancer drugs (chemotherapy), radiation therapy or hormone therapy to prevent a recurrence of breast cancer. […] Your specific treatment will depend on the extent of the cancer and whether your cancer tests positive for certain characteristics, such as having estrogen or progesterone receptors.

• #39 Treatment options for Paget’s disease of the nipple | Cancer Australia

  https://www.canceraustralia.gov.au/cancer-types/breast-cancer/treatment-options/treatment-options-pagets-disease-nipple

  Treatment for Paget’s disease of the nipple will depend on how much of the nipple, areola and breast is involved. […] Where Paget’s disease of the nipple is the only cancer in the breast, treatment usually involves: breast surgery and/or radiotherapy. […] Surgery for Paget’s disease of the nipple usually involves removal the nipple and some surrounding tissue. […] If the nipple is the only area of the breast affected, it’s possible that only the nipple and an area of healthy tissue around it will be removed. This is known as breast conserving surgery. […] Removal of the whole breast (mastectomy) and/or removal of one or more lymph nodes from the armpit may be needed for some patients. […] For women with Paget’s disease of the nipple, radiotherapy is almost always recommended after breast conserving surgery. […] Radiotherapy is sometimes recommended after mastectomy. […] For some women with Paget’s disease of the nipple, radiotherapy may be the only treatment needed after the biopsy used during diagnosis.

• #40 Practical consensus recommendatons for Paget’s disease in breast cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5909301/

  The surgical treatment of Paget’s disease is controversial. Mastectomy with or without axillary lymph node dissection has long been regarded as the standard therapy for Paget’s disease, even in the absence of other clinical signs of malignancy. The underlying mass is often invasive cancer with a high risk of axillary node metastases. The patients have a poorer prognosis and usually the appropriate therapy is based on the pathologic findings of the mass and axillary staging. In the literature, almost all patients treated with local excision, radiotherapy, or both had the clinical presentation of Paget’s disease without a palpable mass. Dixon et al. reported a high recurrence rate of 40% in patients treated with local excision alone, whose mammograms suggested in situ changes confined to the nipple area. Polgr et al. reported a local recurrence rate of 33% with a median follow-up time of 6 years in 33 patients treated with local excision alone with or without underlying ductal carcinoma in situ confined to the nippleareola complex. They concluded that the local excision alone was not an appropriate treatment for patients with Paget’s disease of the nipple.

• #41 Practical consensus recommendatons for Paget’s disease in breast cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5909301/

  With the increasing diagnosis of the early breast cancers and the findings from multiple randomized, prospective trials demonstrating that breast conserving therapy is a feasible alternative for patients with disease limited to the central segment of the breast, the reported techniques for conservative management of Paget’s disease vary widely. These include nipple excision alone (partial or complete), central segmentectomy alone, these resections plus radiation and radiation without resection. Recent reports from several studies with long-term follow-up have shown that breast-conserving surgery is equivalent to mastectomy in terms of overall and disease-free survival in patients with breast cancer. If conservative therapy is adopted, the patient should be followed up carefully with regular mammography. Mastectomy should be reserved for the few occasions, when relapse occurs.

• #42 Update on the surgical management of Paget’s disease – Trebska-McGowan – Gland Surgery

  https://gs.amegroups.org/article/view/2625/html

  Mammary Pagets disease is a rare form of breast neoplasm that often presents with a pruritic eczema-like rash involving the nipple-areolar complex, and is refractory to common remedies. […] In this review, we present an update of the approach to Pagets disease and its surgical treatment. […] Historically, patients with diagnosis of Pagets disease have been treated with mastectomy, because of a high likelihood of association with multicentric and/or multifocal breast cancer. […] The authors concluded that 75% of the patients under investigation would be treated inadequately had they undergone breast preserving surgery consisting of wide local excision of the nipple-areolar complex and excision of the underlying tissue only. […] As a breast conserving therapy has emerged to become the most common treatment of invasive breast cancer, it has become more common in the management of mammary Pagets.

• #43 Paget’s Disease of the Breast: Stages, Symptoms & Prognosis

  https://my.clevelandclinic.org/health/diseases/17913-pagets-disease-of-the-breast

  If you only have Paget’s disease of the nipple or ductal carcinoma in situ (stage 0) that hasn’t spread beyond the milk ducts, your prognosis is excellent. Most people who discover and treat these conditions early will make a full recovery. […] The earlier you identify and treat it, the better your outcome will be. Many people make a full recovery, but it will require surgery to remove it.

• #44

  https://www.nhs.uk/conditions/pagets-disease-nipple/

  Surgery is the main treatment for Paget’s disease of the nipple. Depending on whether the cancer has spread, surgery will either involve removing the whole breast (a mastectomy), or the nipple and areola with the breast tissue underneath them (a central excision). […] If the whole of your breast is removed, breast reconstruction surgery can be used to create a breast shape to match your remaining breast. […] You may also need further treatment if you have invasive breast cancer. This may be a combination of: chemotherapy where powerful medicine is used to destroy cancerous cells, radiotherapy where controlled doses of high-energy radiation are used to destroy cancerous cells, targeted or hormone therapy which lowers the risk of cancer returning in the same breast (and affecting the other breast), and it lowers the risk of cancerous cells spreading elsewhere in the body. […] If Paget’s disease is detected and treated in its early stages, there’s a good chance of a full recovery.

• #45 Paget Disease of the Breast | Details, Diagnosis and Signs | American Cancer Society

  https://www.cancer.org/cancer/types/breast-cancer/about/types-of-breast-cancer/paget-disease-of-the-nipple.html

  Paget disease can be treated by removing the entire breast (mastectomy) or breast-conserving surgery (BCS) followed by whole-breast radiation therapy. If BCS is done, the entire nipple and areola area also needs to be removed. […] If the cancer has spread within the breast tissue (is invasive), the outlook is not as good, and the cancer will be staged and treated like any other invasive ductal carcinoma.

• #46 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Pagets-Disease-of-the-Nipple.aspx

  Mastectomy had been considered the first line of treatment for many years because patients were more commonly found to have more than one tumor within the same breast. […] A sentinel lymph node biopsy is highly recommended for anyone with Paget disease of the nipple undergoing a mastectomy this will test for the spread of cancer to the axillary lymph nodes. A positive result from this will likely indicate the need for a more extensive surgical approach targeting the axillary lymph node. […] Recent studies have shown that breast-conserving surgery that includes removal of the nipple and areola, and subsequent whole-breast radiation therapy, is a viable and safe option for this cancer. This is provided that there is no palpable lump in the breast and tumor detected by mammogram. […] The prognosis depends greatly on the stage of cancer and additional characteristics of the breast tumor cells for example, the presence of hormone receptors for estrogen and progesterone would indicate a need for adjuvant therapy. […] The overall prognosis can be determined by considering the following characteristics in the affected breast: Presence (or absence) of a tumor, Whether any tumor(s) is invasive breast cancer or ductal carcinoma in situ, If relevant, the stage of invasive breast cancer.

• #47

  https://link.springer.com/article/10.1007/s11864-004-0047-x

  Pagets disease of the breast is a relatively rare condition, accounting for 1% to 3% of primary breast cancers. Primary treatment is surgical with adjuvant therapy being dictated by the stage and nature of the underlying tumor. Modified radical mastectomy is the standard of care with breast conservation appropriate in a select group of patients with Pagets disease. This select group includes patients that are diagnosed with nipple-areola changes alone without evidence of a palpable mass or mammographic abnormality. In this group of patients, breast conservation offers local recurrence rates comparable to rates in patients with invasive or noninvasive cancers. In patients diagnosed with associated palpable masses or mammographic abnormalities suggestive of cancer, the recurrence rates are higher and mastectomy is warranted.

• #48 Surgical treatment in Paget’s disease with invasive ductal carcinoma: an observational study based on SEER | Scientific Reports

  https://www.nature.com/articles/srep45510

  In addition to BCS, sentinel lymph node biopsy (SLNB) may be effective in patients with PD; however, its role in PD treatment remains unclear. […] For patients with PD-IDC, the results of multivariate analysis suggested that SLNB was significantly associated with OS during the follow-up period (P=0.028). […] In our series, there was no difference between surgical treatment subgroups. […] The previously reported techniques for BCS in patients with PD have varied widely and include nipple excision and central segmentectomy as well as resection plus radiation. […] There is a place for BCS in selected patients with PD of the breast, especially those with no mass. […] Similarly, these studies supported the use of BCS with radiotherapy as a feasible alternative for patients with PD-IDC.

• #49 Paget’s disease of the breast: Causes, symptoms, treatment, and more

  https://www.medicalnewstoday.com/articles/192362

  These treatments can reduce the risk of the cancer spreading. […] Chemotherapy may help prevent the cancer from returning after treatment, especially if: the tumor was large, the cells had spread to the lymph nodes, the cells are of an aggressive type. […] After treatment finishes, it is essential to attend all follow-up appointments and to continue to monitor for changes.

• #50

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uh4323

  In most cases, there is also some cancer in the breast outside of the nipple area. This type of cancer is treated like other breast cancers, with surgery. You may have breast-conserving surgery and radiation. Mastectomy is also an option. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

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