Topics:
Breast Cancer • Radiation Oncology
How do you manage Paget's disease of the nipple?
Do you think about it in the same way as DCIS in terms of radiation decision making (i.e. grade, margins, age of patient)? Is Paget's disease less likely to recur than DCIS if it involves only the nipple-areolar complex and is completely excised?
Answer from: Radiation Oncologist at Academic Institution
I think of Paget's as a special form of DCIS +/- invasive cancer. We do not routinely perform breast MRI here for this diagnosis (but I can see the utility of this if there is any uncertainty about the extent of the lesion). We consider the local therapy principles to be similar to other...
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Answer from: Radiation Oncologist at Community Practice
This requires imaging including a breast MRI. If the patient has other sites of disease in another quadrant which can be seen in Paget's disease, then I recommend mastectomy. If imaging is negative, then I recommend central lumpectomy (which usually shows DCIS in retroareolar breast tissue) and adju...