Associated with local inflammatory response, pruritus, pain and excoriation
Malignant cells extend to nipple surface through lactiferous ducts
Characteristic eczematoid skin changes of nipple
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
Image-Guided Biopsy
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Ogata H et al: Sonographic visualization of nipple blood flow can help differentiate Paget disease from benign eczematous nipple lesions. PLoS One. 13(5):e0197156, 2018
Zhao Y et al: Clinicopathological characteristics and survival outcomes in Paget disease: a SEER population-based study. Cancer Med. 7(6):2307-18, 2018
Broecker JS et al: An atypical presentation of Paget's Disease of the breast without nipple involvement: Case report and review of the literature. Pathol Res Pract. 213(11):1454-1456, 2017
Elbendary A et al: Diagnostic criteria in intraepithelial pagetoid neoplasms: a histopathologic study and evaluation of select features in Paget disease, Bowen disease, and melanoma in situ. Am J Dermatopathol. 39(6):419-27, 2017
Adams SJ et al: Paget's disease of the male breast in the 21st century: a systematic review. Breast. 29:14-23, 2016
Helme S et al: Breast-conserving surgery in patients with Paget's disease. Br J Surg. 102(10):1167-74, 2015
Wong SM et al: Modern trends in the surgical management of Paget's disease. Ann Surg Oncol. 22(10):3308-16, 2015
Li YJ et al: Local Breast cancer recurrence after mastectomy and breast-conserving surgery for Paget's disease: A meta-analysis. Breast Care (Basel). 9(6):431-4, 2014
Durkan B et al: Paget's disease of the nipple with parenchymal ductal carcinoma in situ is associated with worse prognosis than Paget's disease alone. Am Surg. 79(10):1009-12, 2013
Moon JY et al: Malignant invasion of the nipple-areolar complex of the breast: usefulness of breast MRI. AJR Am J Roentgenol. 201(2):448-55, 2013
Peters MS et al: Dermatopathology of the female breast. Am J Dermatopathol. 35(3):289-304; quiz 305-7, 2013
Spanu A et al: Breast scintigraphy with breast-specific γ-camera in the detection of ductal carcinoma in situ: a correlation with mammography and histologic subtype. J Nucl Med. 53(10):1528-33, 2012
Karakas C: Paget's disease of the breast. J Carcinog. 10:31, 2011
Lim HS et al: Paget disease of the breast: mammographic, US, and MR imaging findings with pathologic correlation. Radiographics. 31(7):1973-87, 2011
Marczyk E et al: The routine immunohistochemical evaluation in Paget disease of the nipple. Pol J Pathol. 62(4):229-35, 2011
Nicholson BT et al: Nipple-areolar complex: normal anatomy and benign and malignant processes. Radiographics. 29(2):509-23, 2009
Da Costa D et al: Common and unusual diseases of the nipple-areolar complex. Radiographics. 27 Suppl 1():S65-77, 2007
Chen CY et al: Paget disease of the breast: changing patterns of incidence, clinical presentation, and treatment in the U.S. Cancer. 107(7):1448-58, 2006
Frei KA et al: Paget disease of the breast: findings at magnetic resonance imaging and histopathologic correlation. Invest Radiol. 40(6):363-7, 2005
Kawase K et al: Paget's disease of the breast: there is a role for breast-conserving therapy. Ann Surg Oncol. 12(5):391-7, 2005
Anderson JM et al: Assessment of Her-2/Neu status by immunohistochemistry and fluorescence in situ hybridization in mammary Paget disease and underlying carcinoma. Appl Immunohistochem Mol Morphol. 11(2):120-4, 2003
Hanna W et al: The role of HER-2/neu oncogene and vimentin filaments in the production of the Paget's phenotype. Breast J. 9(6):485-90, 2003
Marshall JK et al: Conservative management of Paget disease of the breast with radiotherapy: 10- and 15-year results. Cancer. 97(9):2142-9, 2003
Kothari AS et al: Paget disease of the nipple: a multifocal manifestation of higher-risk disease. Cancer. 95(1):1-7, 2002
Polgar C et al: Breast-conserving therapy for Paget disease of the nipple: a prospective European Organization for Research and Treatment of Cancer study of 61 patients. Cancer. 94(6):1904-5, 2002
Bijker N et al: Breast-conserving therapy for Paget disease of the nipple: a prospective European Organization for Research and Treatment of Cancer study of 61 patients. Cancer. 91(3):472-7, 2001
Fu W et al: Paget disease of the breast: analysis of 41 patients. Am J Clin Oncol. 24(4):397-400, 2001
Kollmorgen DR et al: Paget's disease of the breast: a 33-year experience. J Am Coll Surg. 187(2):171-7, 1998
Desai DC et al: Paget's disease of the male breast. Am Surg. 62(12):1068-72, 1996
Jamali FR et al: Paget's disease of the nipple-areola complex. Surg Clin North Am. 76(2):365-81, 1996
Ikeda DM et al: Paget disease of the nipple: radiologic-pathologic correlation. Radiology. 189(1):89-94, 1993
Classic articles in colonic and rectal surgery: Sir James Paget, 1814-1899, on disease of the mammary areola preceeding cancer of the mammary gland. Dis Colon Rectum. 23(4):280-1, 1980
Related Anatomy
Loading...
Related Differential Diagnoses
Loading...
References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Definitions
Adenocarcinoma of epidermis of nipple
Associated with local inflammatory response, pruritus, pain and excoriation
Malignant cells extend to nipple surface through lactiferous ducts
Characteristic eczematoid skin changes of nipple
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
Image-Guided Biopsy
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Ogata H et al: Sonographic visualization of nipple blood flow can help differentiate Paget disease from benign eczematous nipple lesions. PLoS One. 13(5):e0197156, 2018
Zhao Y et al: Clinicopathological characteristics and survival outcomes in Paget disease: a SEER population-based study. Cancer Med. 7(6):2307-18, 2018
Broecker JS et al: An atypical presentation of Paget's Disease of the breast without nipple involvement: Case report and review of the literature. Pathol Res Pract. 213(11):1454-1456, 2017
Elbendary A et al: Diagnostic criteria in intraepithelial pagetoid neoplasms: a histopathologic study and evaluation of select features in Paget disease, Bowen disease, and melanoma in situ. Am J Dermatopathol. 39(6):419-27, 2017
Adams SJ et al: Paget's disease of the male breast in the 21st century: a systematic review. Breast. 29:14-23, 2016
Helme S et al: Breast-conserving surgery in patients with Paget's disease. Br J Surg. 102(10):1167-74, 2015
Wong SM et al: Modern trends in the surgical management of Paget's disease. Ann Surg Oncol. 22(10):3308-16, 2015
Li YJ et al: Local Breast cancer recurrence after mastectomy and breast-conserving surgery for Paget's disease: A meta-analysis. Breast Care (Basel). 9(6):431-4, 2014
Durkan B et al: Paget's disease of the nipple with parenchymal ductal carcinoma in situ is associated with worse prognosis than Paget's disease alone. Am Surg. 79(10):1009-12, 2013
Moon JY et al: Malignant invasion of the nipple-areolar complex of the breast: usefulness of breast MRI. AJR Am J Roentgenol. 201(2):448-55, 2013
Peters MS et al: Dermatopathology of the female breast. Am J Dermatopathol. 35(3):289-304; quiz 305-7, 2013
Spanu A et al: Breast scintigraphy with breast-specific γ-camera in the detection of ductal carcinoma in situ: a correlation with mammography and histologic subtype. J Nucl Med. 53(10):1528-33, 2012
Karakas C: Paget's disease of the breast. J Carcinog. 10:31, 2011
Lim HS et al: Paget disease of the breast: mammographic, US, and MR imaging findings with pathologic correlation. Radiographics. 31(7):1973-87, 2011
Marczyk E et al: The routine immunohistochemical evaluation in Paget disease of the nipple. Pol J Pathol. 62(4):229-35, 2011
Nicholson BT et al: Nipple-areolar complex: normal anatomy and benign and malignant processes. Radiographics. 29(2):509-23, 2009
Da Costa D et al: Common and unusual diseases of the nipple-areolar complex. Radiographics. 27 Suppl 1():S65-77, 2007
Chen CY et al: Paget disease of the breast: changing patterns of incidence, clinical presentation, and treatment in the U.S. Cancer. 107(7):1448-58, 2006
Frei KA et al: Paget disease of the breast: findings at magnetic resonance imaging and histopathologic correlation. Invest Radiol. 40(6):363-7, 2005
Kawase K et al: Paget's disease of the breast: there is a role for breast-conserving therapy. Ann Surg Oncol. 12(5):391-7, 2005
Anderson JM et al: Assessment of Her-2/Neu status by immunohistochemistry and fluorescence in situ hybridization in mammary Paget disease and underlying carcinoma. Appl Immunohistochem Mol Morphol. 11(2):120-4, 2003
Hanna W et al: The role of HER-2/neu oncogene and vimentin filaments in the production of the Paget's phenotype. Breast J. 9(6):485-90, 2003
Marshall JK et al: Conservative management of Paget disease of the breast with radiotherapy: 10- and 15-year results. Cancer. 97(9):2142-9, 2003
Kothari AS et al: Paget disease of the nipple: a multifocal manifestation of higher-risk disease. Cancer. 95(1):1-7, 2002
Polgar C et al: Breast-conserving therapy for Paget disease of the nipple: a prospective European Organization for Research and Treatment of Cancer study of 61 patients. Cancer. 94(6):1904-5, 2002
Bijker N et al: Breast-conserving therapy for Paget disease of the nipple: a prospective European Organization for Research and Treatment of Cancer study of 61 patients. Cancer. 91(3):472-7, 2001
Fu W et al: Paget disease of the breast: analysis of 41 patients. Am J Clin Oncol. 24(4):397-400, 2001
Kollmorgen DR et al: Paget's disease of the breast: a 33-year experience. J Am Coll Surg. 187(2):171-7, 1998
Desai DC et al: Paget's disease of the male breast. Am Surg. 62(12):1068-72, 1996
Jamali FR et al: Paget's disease of the nipple-areola complex. Surg Clin North Am. 76(2):365-81, 1996
Ikeda DM et al: Paget disease of the nipple: radiologic-pathologic correlation. Radiology. 189(1):89-94, 1993
Classic articles in colonic and rectal surgery: Sir James Paget, 1814-1899, on disease of the mammary areola preceeding cancer of the mammary gland. Dis Colon Rectum. 23(4):280-1, 1980
STATdx includes over 200,000 searchable images, including x-ray, CT, MR, and ultrasound images. To access all images, please log in or subscribe.