A 40-year-old woman notices a skin rash around her areola

Discussion in 'MRCS Forum' started by Ketty., Mar 11, 2008.

  1. Ketty.

    Ketty. Guest

    A 40-year-old woman notices a skin rash around her areola there is an erosive area about the nipple. There is tenderness, itching and intermittent bleeding. This entity -
    a- Usually precedes development of Paget’s disease of bone
    b- Presents with nipple-areolar eczematous changes
    c- Does not involve axillary lymph nodes because it is a manifestation of Intraductal carcinoma only
    d- Accounts for 10 to 15% of all newly diagnosed breast cancers
    e- Is adequately treated with wide excision when it presents as a mass
  2. Ketty.

    Ketty. Guest

    The correct Answer is : b.

    Explanation : (Harris, pp 870-876) Paget’s disease of the breast is unrelated to Paget’s disease of bone. It represents a small percentage (1 to 3%) of all breast cancers and is thought to originate in the retroareolar lactiferous ducts. It progresses toward the nipple-areola complex in most patients, where it causes the typical clinical finding of nipple eczema and erosion. Up to 20% of patients with Paget’s disease have an associated breast mass, and these patients are more likely to have involvement of axillary nodes. Nipple-areolar disease alone usually represents in situ cancer; these patients have a 10-year survival rate of over 80%. In contrast, if Paget’s disease presents with a mass, the mass is likely to be an infiltrating ductal carcinoma. The generally recommended surgical procedure for Paget’s disease is currently a modified radical mastectomy. The validity of breast-saving surgery and adjuvant radiation therapy for patients without an associated mass is under investigation.

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