Choroba pageta sutka – Rokowania, prognozy i postęp choroby

Choroba pageta sutka
Rokowania, prognozy i postęp choroby

Choroba Pageta sutka to rzadki nowotwór piersi, rozpoczynający się w przewodach mlekowych i obejmujący brodawkę oraz otoczkę. Rokowanie zależy od obecności towarzyszącego raka inwazyjnego, stopnia zaawansowania (wg AJCC) oraz innych czynników klinicznych. Według danych SEER, 5-letni względny wskaźnik przeżycia dla wszystkich pacjentek wynosi 82,6%, co jest nieco gorsze niż dla ogólnego raka piersi (87,1%). Wyróżnia się trzy postacie kliniczne: PDDCIS z 5-letnim przeżyciem 97,5%-98,2%, izolowaną chorobę Pageta (PD) z przeżyciem 72,9%-92,4% oraz PDIDC z inwazyjnym rakiem przewodowym, gdzie przeżycie wynosi 71,4%-84,1%. Stopień zaawansowania znacząco wpływa na przeżycie: I – 95,8%, II – 77,7%, III – 46,3%, IV – 14,3%. Dodatkowo, gorsze rokowanie obserwuje się u starszych pacjentek, osób niezamężnych oraz przy obecności przerzutów do węzłów chłonnych, dużym guzie, wysokim stopniu zróżnicowania histologicznego oraz negatywnym statusie receptorów ER i HER2.

Choroba Pageta sutka (Paget’s disease of the nipple) – rokowanie

Choroba Pageta sutka to rzadki typ nowotworu piersi, który rozpoczyna się w przewodach mlekowych i obejmuje brodawkę sutkową oraz otoczkę. Rokowanie w tej chorobie zależy od wielu czynników, w tym obecności towarzyszącego raka inwazyjnego, stopnia zaawansowania choroby oraz szybkości wdrożenia leczenia.¹²

Wskaźniki przeżycia

Według danych z programu SEER (Surveillance, Epidemiology, and End Results) Narodowego Instytutu Raka w USA, 5-letni względny wskaźnik przeżycia dla wszystkich kobiet ze zdiagnozowaną chorobą Pageta sutka w latach 1988-2001 wynosił 82,6%. Dla porównania, 5-letni względny wskaźnik przeżycia dla kobiet z jakimkolwiek typem raka piersi wynosił 87,1%.³⁴

Choroba Pageta sutka może występować w różnych postaciach klinicznych, co wpływa na rokowanie:⁵

PDDCIS (Paget’s disease z towarzyszącym rakiem przewodowym in situ) – najlepsze rokowanie z 5-letnim wskaźnikiem przeżycia wynoszącym 97,5%-98,2%
PD (sama choroba Pageta) – 5-letni wskaźnik przeżycia wynosi 72,9%-92,4%
PDIDC (Paget’s disease z towarzyszącym inwazyjnym rakiem przewodowym) – najgorsze rokowanie z 5-letnim wskaźnikiem przeżycia wynoszącym 71,4%-84,1%

⁶

Czynniki wpływające na rokowanie

Na rokowanie w chorobie Pageta sutka wpływa wiele czynników:⁷⁸⁹

Obecność inwazyjnego raka w zajętej piersi oraz rozprzestrzenienie się nowotworu do pobliskich węzłów chłonnych są związane ze zmniejszonym przeżyciem
Stopień zaawansowania (AJCC) – dla kobiet z chorobą Pageta sutka i inwazyjnym rakiem w tej samej piersi, 5-letnie względne przeżycie maleje wraz ze wzrostem stopnia zaawansowania nowotworu:
- Stopień I: 95,8%
- Stopień II: 77,7%
- Stopień III: 46,3%
- Stopień IV: 14,3%
Wiek w momencie diagnozy – starszy wiek jest związany z gorszym rokowaniem
Stan cywilny – osoby w związku małżeńskim mają lepsze rokowanie (5-letni OS 85,6%) niż osoby niezamężne/nieżonate (5-letni OS 65,2%)
Wielkość guza
Status węzłów chłonnych
Stopień zróżnicowania histologicznego guza (grading)
Status receptorów estrogenowych (ER) i status HER2

¹⁰¹¹¹²

Rokowanie w zależności od typu choroby

Choroba Pageta sutka może występować jako:

Izolowana postać – gdy zmiany ograniczają się tylko do brodawki i otoczki
Z towarzyszącym DCIS (rak przewodowy in situ) – komórki rakowe rozwinęły się w przewodach mlekowych, ale nie mają zdolności rozprzestrzeniania się poza przewody do otaczającej tkanki piersi ani do innych części ciała
Z towarzyszącym rakiem inwazyjnym – ma potencjał do rozprzestrzeniania się z piersi do innych części ciała

¹³¹⁴

Jeśli choroba Pageta sutka występuje tylko jako DCIS (stopień 0) i nie rozprzestrzeniła się poza przewody mlekowe, rokowanie jest doskonałe. Większość osób, które wcześnie wykryją i leczą te stany, całkowicie wyzdrowieje. Gdy rak piersi zaczyna się rozprzestrzeniać, staje się coraz trudniejszy do wyleczenia.¹⁵¹⁶

Narzędzia prognostyczne

Ze względu na gorsze rokowanie choroby Pageta w porównaniu z innymi typami raka piersi, opracowano specjalne narzędzia prognostyczne. Stworzono nomogramy prognostyczne uwzględniające różne wskaźniki kliniczno-patologiczne dla pacjentów z chorobą Pageta sutka. Te nomogramy zapewniają dokładną ocenę prognostyczną i pomagają klinicystom w wyborze odpowiednich strategii leczenia.¹⁷¹⁸

Niezależnymi czynnikami związanymi z całkowitym przeżyciem (OS) są: stopień zróżnicowania guza, typ histologiczny, stopień AJCC, operacja, chemioterapia i stan cywilny. Z kolei czynnikami związanymi z przeżyciem specyficznym dla raka (CSS) są: stopień zróżnicowania guza, typ histologiczny, stopień AJCC i wiek.¹⁹

Znaczenie wczesnej diagnozy

Im wcześniej choroba Pageta sutka zostanie zidentyfikowana i leczona, tym lepsze będą wyniki leczenia. Wielu pacjentów może całkowicie wyzdrowieć, ale będzie to wymagało operacji w celu usunięcia zmiany. Objawy, takie jak łuszczenie się skóry brodawki, wydzielina lub surowy obszar, który nie goi się, powinny skłonić do natychmiastowej konsultacji lekarskiej.²⁰

Ponieważ choroba Pageta sutka jest rzadka, przeprowadzenie randomizowanych kontrolowanych badań klinicznych jest trudne. Jednakże, wraz ze zmianą obecnych metod leczenia, ogólne rokowanie może się poprawiać.²¹

Znaczenie spersonalizowanego leczenia

Obserwacje podkreślają znaczenie zindywidualizowanego leczenia w chorobie Pageta sutka. Na podstawie opracowanych nomogramów ryzykowych, lekarze mogą lepiej kierować procesem decyzyjnym i monitorowaniem choroby, co może prowadzić do poprawy rokowań.²²²³

Podsumowując, choroba Pageta sutka to rzadki nowotwór o zróżnicowanym rokowaniu, zależnym głównie od obecności towarzyszącego raka inwazyjnego, stopnia zaawansowania, wieku pacjenta i innych czynników klinicznych. Wczesne wykrycie i leczenie znacząco poprawiają rokowanie, zwłaszcza w przypadkach ograniczonych do brodawki sutkowej lub przewodów mlekowych.

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Materiały źródłowe

#1 Paget’s Disease of the Breast: Stages, Symptoms & Prognosis
https://my.clevelandclinic.org/health/diseases/17913-pagets-disease-of-the-breast
Breast cancer survival is based on the stage of the cancer when its detected. If you only have Paget’s disease of the nipple or ductal carcinoma in situ (stage 0) that hasnt spread beyond the milk ducts, your prognosis is excellent. Most people who discover and treat these conditions early will make a full recovery. Once breast cancer begins to spread, it becomes progressively harder to beat. […] Paget’s disease of the breast is early-stage breast cancer of the milk ducts that occurs in the nipple. Its sometimes accompanied by more invasive breast cancer. You may notice nipple changes such as crusting, flaking of the skin, discharge or a raw area that doesnt heal. 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.
#2 Paget Disease of the Breast – NCI
https://www.cancer.gov/types/breast/paget-breast-fact-sheet
What is the prognosis for people with Paget disease of the breast? […] The prognosis, or outlook, for people with Paget disease of the breast depends on a variety of factors, including the following: […] The presence of invasive cancer in the affected breast and the spread of cancer to nearby lymph nodes are associated with reduced survival. […] According to NCIs Surveillance, Epidemiology, and End Results program, the 5-year relative survival for all women in the United States who were diagnosed with Paget disease of the breast between 1988 and 2001 was 82.6 percent. This compares with a 5-year relative survival of 87.1 percent for women diagnosed with any type of breast cancer. For women with both Paget disease of the breast and invasive cancer in the same breast, the 5-year relative survival declined with increasing stage of the cancer (stage I, 95.8 percent; stage II, 77.7 percent; stage III, 46.3 percent; stage IV, 14.3 percent) (1, 3, 8, 9).
#3 Paget Disease of the Breast – NCI
https://www.cancer.gov/types/breast/paget-breast-fact-sheet
What is the prognosis for people with Paget disease of the breast? […] The prognosis, or outlook, for people with Paget disease of the breast depends on a variety of factors, including the following: […] The presence of invasive cancer in the affected breast and the spread of cancer to nearby lymph nodes are associated with reduced survival. […] According to NCIs Surveillance, Epidemiology, and End Results program, the 5-year relative survival for all women in the United States who were diagnosed with Paget disease of the breast between 1988 and 2001 was 82.6 percent. This compares with a 5-year relative survival of 87.1 percent for women diagnosed with any type of breast cancer. For women with both Paget disease of the breast and invasive cancer in the same breast, the 5-year relative survival declined with increasing stage of the cancer (stage I, 95.8 percent; stage II, 77.7 percent; stage III, 46.3 percent; stage IV, 14.3 percent) (1, 3, 8, 9).
#4 Paget’s Disease of the Breast: Symptoms, Treatment & Prognosis
https://www.cancercenter.com/cancer-types/breast-cancer/types/rare-breast-cancer-types/pagets-disease-of-the-breast
Survival rates differ depending on the severity of Pagets disease. The five-year relative survival rate for women with Pagets disease in the United States between 1988 and 2001 was 82.6 percent, according to the NCI. […] As current treatments change, the overall outlook may improve. […] Since Pagets disease is rare, randomized controlled clinical trials are hard to perform. But patients researching this option have a database available of NCI-supported clinical trials.
#5 Clinicopathological characteristics and survival outcomes in Paget disease: a SEER populationâbased study
https://pmc.ncbi.nlm.nih.gov/articles/PMC6010794/
The outcomes of these subtypes of breast carcinoma were different. Based on the overall survival, the patients with PDIDC had the worst prognosis (5-year survival rate = 84.1%). The PDDCIS had the best prognosis (5-year survival rate = 97.5%). […] Among three subtypes of Paget disease, patients with PDIDC had the worst prognosis. Besides, patients who were unmarried had worse outcomes. […] The observation underscores the importance of individualized treatment. […] Patients with PDDCIS had the best prognosis with a 5-year OS 83.6%. The one worse than the PDDCIS was IDC. The 5-year OS of patients with IDC was 81.1%. Then, the next one was PD. The 5-year OS of patients with PD was 72.9%. The one with worst outcomes was PDIDC, whose 5-year OS was 71.4%. […] The patients with PDDCIS had the best prognosis with a 5-year survival rate of 98.2%. The worse one was patients with PD. Its 5-year survival rate was 92.4%. The survival rate of patients with IDC was 91%. And patients who were diagnosed with PDIDC had the worst outcomes. Its 5-year survival rate was 84.1%.
#6 Clinicopathological characteristics and survival outcomes in Paget disease: a SEER populationâbased study
https://pmc.ncbi.nlm.nih.gov/articles/PMC6010794/
The outcomes of these subtypes of breast carcinoma were different. Based on the overall survival, the patients with PDIDC had the worst prognosis (5-year survival rate = 84.1%). The PDDCIS had the best prognosis (5-year survival rate = 97.5%). […] Among three subtypes of Paget disease, patients with PDIDC had the worst prognosis. Besides, patients who were unmarried had worse outcomes. […] The observation underscores the importance of individualized treatment. […] Patients with PDDCIS had the best prognosis with a 5-year OS 83.6%. The one worse than the PDDCIS was IDC. The 5-year OS of patients with IDC was 81.1%. Then, the next one was PD. The 5-year OS of patients with PD was 72.9%. The one with worst outcomes was PDIDC, whose 5-year OS was 71.4%. […] The patients with PDDCIS had the best prognosis with a 5-year survival rate of 98.2%. The worse one was patients with PD. Its 5-year survival rate was 92.4%. The survival rate of patients with IDC was 91%. And patients who were diagnosed with PDIDC had the worst outcomes. Its 5-year survival rate was 84.1%.
#7 Paget Disease of the Breast – NCI
https://www.cancer.gov/types/breast/paget-breast-fact-sheet
What is the prognosis for people with Paget disease of the breast? […] The prognosis, or outlook, for people with Paget disease of the breast depends on a variety of factors, including the following: […] The presence of invasive cancer in the affected breast and the spread of cancer to nearby lymph nodes are associated with reduced survival. […] According to NCIs Surveillance, Epidemiology, and End Results program, the 5-year relative survival for all women in the United States who were diagnosed with Paget disease of the breast between 1988 and 2001 was 82.6 percent. This compares with a 5-year relative survival of 87.1 percent for women diagnosed with any type of breast cancer. For women with both Paget disease of the breast and invasive cancer in the same breast, the 5-year relative survival declined with increasing stage of the cancer (stage I, 95.8 percent; stage II, 77.7 percent; stage III, 46.3 percent; stage IV, 14.3 percent) (1, 3, 8, 9).
#8 Clinicopathological characteristics and survival outcomes in Paget disease: a SEER populationâbased study
https://pmc.ncbi.nlm.nih.gov/articles/PMC6010794/
For PD, indicators which had significance were age at diagnosis (P 0.001), marital status (P 0.001), tumor size (P 0.001), lymph node status (P 0.001), and AJCC stage (P 0.001). For PDIDC, the significant indicators were age at diagnosis, marital status, tumor size, lymph node status, Grade, AJCC stage, and ER status. […] The significant indicators of the patients with PDDCIS were age at diagnosis (P 0.001), marital status (P 0.001), tumor size (P 0.001), lymph node status (P 0.001), AJCC stage (P 0.001), HER2 status (P 0.001), and radiation or not (P = 0.007). […] For patients with PD (Fig. 3A), the married patients had the best prognosis with a 5-year OS of 85.6%. The unmarried patients (included single patients who never married, widowed, divorced, and separated patients) had worse outcomes with a 5-year OS of 65.2%. […] In conclusion, our study showed patients with PDIDC have the worst prognosis. Among all these three kinds of Paget disease, unmarried patients had worse outcomes. And the marital status of patients with PDIDC is associated with hormone status and HER2 status.
#9
https://pmc.ncbi.nlm.nih.gov/articles/PMC8851527/
Paget disease of the breast is an uncommon malignant tumor with an inferior outcome. Therefore, establishing nomograms to predict the survival outcomes of breast Paget disease patients is urgent. Tumor grade, histological type, American Joint Committee on Cancer (AJCC) stage, surgery, chemotherapy, and marital status were confirmed as independent overall survival (OS)-related factors; tumor grade, histological type, AJCC stage, and age were associated with independent cancer-specific survival (CSS)-related factors. The values of the C-index for OS nomogram acquired were 0.827 and 0.745 for training and validation cohorts, respectively. Meanwhile, the corresponding values of the C-index to CSS nomogram were 0.890 and 0.655, respectively. The calibration curves and decision curve analysis indicated that both nomograms had an excellent performance. In conclusion, two valuable nomograms incorporating various clinicopathological indicators were established for breast Paget disease patients. These prognostic nomograms provide accurate prognostic assessment for breast Paget disease patients and help clinicians select appropriate treatment strategies.
#10 Clinicopathological characteristics and survival outcomes in Paget disease: a SEER populationâbased study
https://pmc.ncbi.nlm.nih.gov/articles/PMC6010794/
For PD, indicators which had significance were age at diagnosis (P 0.001), marital status (P 0.001), tumor size (P 0.001), lymph node status (P 0.001), and AJCC stage (P 0.001). For PDIDC, the significant indicators were age at diagnosis, marital status, tumor size, lymph node status, Grade, AJCC stage, and ER status. […] The significant indicators of the patients with PDDCIS were age at diagnosis (P 0.001), marital status (P 0.001), tumor size (P 0.001), lymph node status (P 0.001), AJCC stage (P 0.001), HER2 status (P 0.001), and radiation or not (P = 0.007). […] For patients with PD (Fig. 3A), the married patients had the best prognosis with a 5-year OS of 85.6%. The unmarried patients (included single patients who never married, widowed, divorced, and separated patients) had worse outcomes with a 5-year OS of 65.2%. […] In conclusion, our study showed patients with PDIDC have the worst prognosis. Among all these three kinds of Paget disease, unmarried patients had worse outcomes. And the marital status of patients with PDIDC is associated with hormone status and HER2 status.
#11
https://pmc.ncbi.nlm.nih.gov/articles/PMC8851527/
Paget disease of the breast is an uncommon malignant tumor with an inferior outcome. Therefore, establishing nomograms to predict the survival outcomes of breast Paget disease patients is urgent. Tumor grade, histological type, American Joint Committee on Cancer (AJCC) stage, surgery, chemotherapy, and marital status were confirmed as independent overall survival (OS)-related factors; tumor grade, histological type, AJCC stage, and age were associated with independent cancer-specific survival (CSS)-related factors. The values of the C-index for OS nomogram acquired were 0.827 and 0.745 for training and validation cohorts, respectively. Meanwhile, the corresponding values of the C-index to CSS nomogram were 0.890 and 0.655, respectively. The calibration curves and decision curve analysis indicated that both nomograms had an excellent performance. In conclusion, two valuable nomograms incorporating various clinicopathological indicators were established for breast Paget disease patients. These prognostic nomograms provide accurate prognostic assessment for breast Paget disease patients and help clinicians select appropriate treatment strategies.
#12
https://pmc.ncbi.nlm.nih.gov/articles/PMC8851527/
Breast Paget disease is a rare subtype of breast cancer. Unfortunately, its prognosis is worse than other types of breast cancers. Many risk factors and prognostic variables have been identified, but there is no thorough research focused on developing the prognostic prediction tools for breast Paget disease, which indicates that the probability of prognosis cannot be well assessed. […] This study constructed two prognostic nomograms incorporating corresponding independent prognostic clinical factors to better predict OS and CSS, respectively, for breast PD patients. Both nomograms performed well in discrimination and calibration. More importantly, the nomogram-based risk stratification systems were constructed to guide clinicians in decision making and disease monitoring.
#13 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/
Most people with Pagets disease will have an early form of breast cancer called ductal carcinoma in situ (DCIS) under the nipple or elsewhere in the breast. […] DCIS means cancer cells have developed within the milk ducts but have not yet developed the ability to spread outside of the ducts into the surrounding breast tissue or to other parts of the body. As a result, DCIS has a good outlook (prognosis) when treated. […] Although the size and grade of the DCIS may help predict if it will become invasive, theres currently no way of knowing for certain if this will happen. […] Some people with Pagets disease will also have an underlying invasive breast cancer. […] Invasive breast cancer has the potential to spread from the breast to other parts of the body.
#14 Paget’s Disease of the Breast: Stages, Symptoms & Prognosis
https://my.clevelandclinic.org/health/diseases/17913-pagets-disease-of-the-breast
Breast cancer survival is based on the stage of the cancer when its detected. If you only have Paget’s disease of the nipple or ductal carcinoma in situ (stage 0) that hasnt spread beyond the milk ducts, your prognosis is excellent. Most people who discover and treat these conditions early will make a full recovery. Once breast cancer begins to spread, it becomes progressively harder to beat. […] Paget’s disease of the breast is early-stage breast cancer of the milk ducts that occurs in the nipple. Its sometimes accompanied by more invasive breast cancer. You may notice nipple changes such as crusting, flaking of the skin, discharge or a raw area that doesnt heal. 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.
#15 Paget’s Disease of the Breast: Stages, Symptoms & Prognosis
https://my.clevelandclinic.org/health/diseases/17913-pagets-disease-of-the-breast
Breast cancer survival is based on the stage of the cancer when its detected. If you only have Paget’s disease of the nipple or ductal carcinoma in situ (stage 0) that hasnt spread beyond the milk ducts, your prognosis is excellent. Most people who discover and treat these conditions early will make a full recovery. Once breast cancer begins to spread, it becomes progressively harder to beat. […] Paget’s disease of the breast is early-stage breast cancer of the milk ducts that occurs in the nipple. Its sometimes accompanied by more invasive breast cancer. You may notice nipple changes such as crusting, flaking of the skin, discharge or a raw area that doesnt heal. 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.
#16 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/
Most people with Pagets disease will have an early form of breast cancer called ductal carcinoma in situ (DCIS) under the nipple or elsewhere in the breast. […] DCIS means cancer cells have developed within the milk ducts but have not yet developed the ability to spread outside of the ducts into the surrounding breast tissue or to other parts of the body. As a result, DCIS has a good outlook (prognosis) when treated. […] Although the size and grade of the DCIS may help predict if it will become invasive, theres currently no way of knowing for certain if this will happen. […] Some people with Pagets disease will also have an underlying invasive breast cancer. […] Invasive breast cancer has the potential to spread from the breast to other parts of the body.
#17
https://pmc.ncbi.nlm.nih.gov/articles/PMC8851527/
Paget disease of the breast is an uncommon malignant tumor with an inferior outcome. Therefore, establishing nomograms to predict the survival outcomes of breast Paget disease patients is urgent. Tumor grade, histological type, American Joint Committee on Cancer (AJCC) stage, surgery, chemotherapy, and marital status were confirmed as independent overall survival (OS)-related factors; tumor grade, histological type, AJCC stage, and age were associated with independent cancer-specific survival (CSS)-related factors. The values of the C-index for OS nomogram acquired were 0.827 and 0.745 for training and validation cohorts, respectively. Meanwhile, the corresponding values of the C-index to CSS nomogram were 0.890 and 0.655, respectively. The calibration curves and decision curve analysis indicated that both nomograms had an excellent performance. In conclusion, two valuable nomograms incorporating various clinicopathological indicators were established for breast Paget disease patients. These prognostic nomograms provide accurate prognostic assessment for breast Paget disease patients and help clinicians select appropriate treatment strategies.
#18
https://pmc.ncbi.nlm.nih.gov/articles/PMC8851527/
Breast Paget disease is a rare subtype of breast cancer. Unfortunately, its prognosis is worse than other types of breast cancers. Many risk factors and prognostic variables have been identified, but there is no thorough research focused on developing the prognostic prediction tools for breast Paget disease, which indicates that the probability of prognosis cannot be well assessed. […] This study constructed two prognostic nomograms incorporating corresponding independent prognostic clinical factors to better predict OS and CSS, respectively, for breast PD patients. Both nomograms performed well in discrimination and calibration. More importantly, the nomogram-based risk stratification systems were constructed to guide clinicians in decision making and disease monitoring.
#19
https://pmc.ncbi.nlm.nih.gov/articles/PMC8851527/
Paget disease of the breast is an uncommon malignant tumor with an inferior outcome. Therefore, establishing nomograms to predict the survival outcomes of breast Paget disease patients is urgent. Tumor grade, histological type, American Joint Committee on Cancer (AJCC) stage, surgery, chemotherapy, and marital status were confirmed as independent overall survival (OS)-related factors; tumor grade, histological type, AJCC stage, and age were associated with independent cancer-specific survival (CSS)-related factors. The values of the C-index for OS nomogram acquired were 0.827 and 0.745 for training and validation cohorts, respectively. Meanwhile, the corresponding values of the C-index to CSS nomogram were 0.890 and 0.655, respectively. The calibration curves and decision curve analysis indicated that both nomograms had an excellent performance. In conclusion, two valuable nomograms incorporating various clinicopathological indicators were established for breast Paget disease patients. These prognostic nomograms provide accurate prognostic assessment for breast Paget disease patients and help clinicians select appropriate treatment strategies.
#20 Paget’s Disease of the Breast: Stages, Symptoms & Prognosis
https://my.clevelandclinic.org/health/diseases/17913-pagets-disease-of-the-breast
Breast cancer survival is based on the stage of the cancer when its detected. If you only have Paget’s disease of the nipple or ductal carcinoma in situ (stage 0) that hasnt spread beyond the milk ducts, your prognosis is excellent. Most people who discover and treat these conditions early will make a full recovery. Once breast cancer begins to spread, it becomes progressively harder to beat. […] Paget’s disease of the breast is early-stage breast cancer of the milk ducts that occurs in the nipple. Its sometimes accompanied by more invasive breast cancer. You may notice nipple changes such as crusting, flaking of the skin, discharge or a raw area that doesnt heal. 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.
#21 Paget’s Disease of the Breast: Symptoms, Treatment & Prognosis
https://www.cancercenter.com/cancer-types/breast-cancer/types/rare-breast-cancer-types/pagets-disease-of-the-breast
Survival rates differ depending on the severity of Pagets disease. The five-year relative survival rate for women with Pagets disease in the United States between 1988 and 2001 was 82.6 percent, according to the NCI. […] As current treatments change, the overall outlook may improve. […] Since Pagets disease is rare, randomized controlled clinical trials are hard to perform. But patients researching this option have a database available of NCI-supported clinical trials.
#22 Clinicopathological characteristics and survival outcomes in Paget disease: a SEER populationâbased study
https://pmc.ncbi.nlm.nih.gov/articles/PMC6010794/
The outcomes of these subtypes of breast carcinoma were different. Based on the overall survival, the patients with PDIDC had the worst prognosis (5-year survival rate = 84.1%). The PDDCIS had the best prognosis (5-year survival rate = 97.5%). […] Among three subtypes of Paget disease, patients with PDIDC had the worst prognosis. Besides, patients who were unmarried had worse outcomes. […] The observation underscores the importance of individualized treatment. […] Patients with PDDCIS had the best prognosis with a 5-year OS 83.6%. The one worse than the PDDCIS was IDC. The 5-year OS of patients with IDC was 81.1%. Then, the next one was PD. The 5-year OS of patients with PD was 72.9%. The one with worst outcomes was PDIDC, whose 5-year OS was 71.4%. […] The patients with PDDCIS had the best prognosis with a 5-year survival rate of 98.2%. The worse one was patients with PD. Its 5-year survival rate was 92.4%. The survival rate of patients with IDC was 91%. And patients who were diagnosed with PDIDC had the worst outcomes. Its 5-year survival rate was 84.1%.
#23
https://pmc.ncbi.nlm.nih.gov/articles/PMC8851527/
Breast Paget disease is a rare subtype of breast cancer. Unfortunately, its prognosis is worse than other types of breast cancers. Many risk factors and prognostic variables have been identified, but there is no thorough research focused on developing the prognostic prediction tools for breast Paget disease, which indicates that the probability of prognosis cannot be well assessed. […] This study constructed two prognostic nomograms incorporating corresponding independent prognostic clinical factors to better predict OS and CSS, respectively, for breast PD patients. Both nomograms performed well in discrimination and calibration. More importantly, the nomogram-based risk stratification systems were constructed to guide clinicians in decision making and disease monitoring.