Paget’s disease

Paget’s disease

Paget’s disease is a unique type of DCIS arising in the nipple. It presents as erosion of the nipple that slowly destroys the nipple and encroaches on the areola ( Figure 58.19 ). It may become invasive with metastasis to the axillary lymph nodes. Triple assessment is needed to exclude underlying malignancy . Paget’s disease without associated underlying malignancy is treated by central core excision, removing a cone of major milk ducts along with the nipple and areola down to the pectoralis major muscle, followed by radiotherapy . Paget’s disease with Sir James Paget , 1814–1899, surgeon, St Bartholomew’s Hospital, London, UK, described this disease of the nipple in 1874. underlying malignancy is treated by mastectomy and evalua - tion of the axillary nodal status.

Figure 58.19 Nipple erosion in early Paget’s disease.