Study On The Relationship Between Mammary Paget’s Disease And Ductal Carcinoma Of The Breast

Objective:Through retrospective analysis of estrogen receptor(ER),progesterone receptor(PR),epidermal growth factor receptor-2(HER-2),Ki-67 and clinical data in patients with mammary Paget’s disease(MPD),ductal carcinoma in situ(DCIS)and invasive ductal carcinoma(IDC),the relationship between MPD and ductal carcinoma of the breast was discussed,and then the origin of MPD cells was analyzed.Methods:A retrospective analysis was made of 152 patients with breast cancer from XX Hospital from 2010 to 2019,including 41 patients with MPD(4 patients with simple Paget’s disease,27 patients with Paget’s disease with ductal carcinoma in situ,10 patients with Paget’s disease with invasive ductal carcinoma),52 patients with DCIS,and 59 patients with IDC.All skin biopsy specimens were fixed with 10% formalin solution,and paraffin-embedded tissue sections were made with continuous sections of 4 μm thick.Immunohistochemical detection of ER,PR,HER-2 and Ki-67 were performed on each surgical specimen by En Vision two-step method.The positive rates of ER,PR,HER-2,Ki-67 and clinical data of the three groups were compared,and the data were statistically analyzed.P<0.05 was considered statistically significant.Result:The positive rate of ER was statistically different among the three groups(p<0.05),and the positive rate of Ki-67 was not statistically different among the three groups(p>0.05).There was no statistical difference in the positive rates of PR and HER-2 between DCIS and IDC(p>0.05),but there was statistical difference in the positive rates of PR and HER-2 between MPD and the above two groups(p<0.05).Conclusion:Comparing the immunophenotypes and clinical data of MPD with DCIS and IDC,it was found that the three groups had different clinical manifestations and immunohistochemical pathological features,indicating that the etiology and pathogenesis of MPD and breast ductal cancer may be different and are different tumor entities.In MPD group,simple breast Paget disease,breast Paget disease with ductal Carcinoma in situ,and breast Paget disease with invasive ductal carcinoma have similar immunohistochemical characteristics,suggesting that MPD intraepidermal lesions and associated breast ductal lesions are continuous and not independent.