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vol.70 issue1PREVALENCE OF POTENTIALLY PATHOGENIC MICROBIOLOGICAL AGENTS IN VAGINAL EXUDATES OF ASYMPTOMATIC PREGNANT WOMEN, BARRANQUILLA, COLOMBIA, 2014-2015 author indexsubject indexarticles search
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Revista Colombiana de Obstetricia y Ginecología

Print version ISSN 0034-7434
On-line version ISSN 2463-0225

Abstract

MATAMOROS-PARRA, Liseth Johana; VERTEL-VELASQUEZ, Miguel Andrés  and  CAMARGO-VILLALBA, Gloria Eugenia. Paget’s disease of the breast without associated ductal carinoma: Case report and review of the literature. Rev Colomb Obstet Ginecol [online]. 2019, vol.70, n.1, pp.58-67. ISSN 0034-7434.  http://dx.doi.org/10.18597/rcog.3193.

Objective:

To present one case of Paget’s disease (PD) of the breast without associated ductal carcinoma, and to conduct a review of the literature on its diagnosis and treatment.

Materials and methods:

A 59-year-old woman with a two-year history of a chronic erythematous, ulcerated, itchy lesion in the left nipple, initially treated dermatologically with topical steroids with no improvement, finally visits a primary healthcare institution in the city of Tunja, Colombia for diagnosis. A biopsy and histochemical testing were performed to make the diagnosis and the lesion was then treated with central quadrantectomy. The post-operative pathology testing was negative for malignancy, without recurrence at one-year follow-up. A search was conducted in the PubMed, SciELO, ProQuest, ScienceDirect and Google Scholar databases using the terms “Paget´s Disease,” “Breast Neoplasms,” “Mammography,” “Ultrasonography,” Mammary,” “Biopsy,” and “Mastectomy,” tracking bibliographic review articles, editorials, reports and clinical case series in English and Spanish, without time limitation.

Results:

Overall, 11 publications were included consisting of 5 case reports, 3 case series, 1 review of the literature based on a clinical case, and 2 letters to the editor describing cases related to Paget’s disease of the nipple with no associated carcinoma. The diagnosis was based on the clinical suspicion of the disease and a biopsy of the lesion. Histochemistry was useful for the differential diagnosis: treatment options ranged from mastectomy to nipple-areolar complex resection. Radiotherapy has also been used.

Conclusions:

The diagnosis of Paget’s disease with no associated ductal carcinoma is based on early clinical suspicion and histopathology of the nipple-areolar complex. There is no consensus regarding surgical management of this lesion. Follow-up studies of this subgroup of patients treated with radiotherapy or conservative surgery are required.

Keywords : Paget’s disease of the breast; breast neoplasms; mammography; mammary ultrasound; biopsy; mastectomy.

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