A Case Report Of 17 Mammary Paget's Disease Patients

Objective: MPD is one kind of breast cancer. We summarize the clinical characteristics, suitable diagnosis and treatments, and analyzed the factors which can affect the prognosis of MPD patients.Methods: we cumulated 17 MPD patients who were addicted in The first hospital of Jilin university from Jan.1st 1999 to Mar.1st 2008. According the tumor size, the condition axillary lymph nodes involved, the onset age of the disease, and the hormone receptor, we choose 166 patients of breast infiltrative ductal carcinoma in the same period to do contrasting analysis with the MPD patients companied with infiltrative ductal carcinoma. We want to see if the survival rate is different between the two groups.Results: For the MPD patients the erosion change of the nipple/areola area of breast is the main clinical features. 41.18% (7/17) of the patients have underlying mass. For the pathologic results of the patients, 5.9 %( 1/17) is ductal carcinoma in situ. 70.59% (12/17) is infiltrative ductal carcinoma. The patients companied with underlying mass all showed breast ductal invasive carcinoma. 50% (5/10) patients are hormone receptor positive. 80% (8/10) patients are HER2 positive. We followed 10 patients of MPD, in five years we found 1 patient died, and 1 patient have local recurrence. And in breast infiltrative carcinoma group there are 8 patients have died of 130 patients who have been followed up. The 5-year total survival rate and disease free survival rate are 90%, 80%and 90.59%, 78.82%, respectively (P>0.05). There is no difference between them.Conclusion: The main clinical presentation of Paget's disease of breast is the eczematous eruption at the nipple/areola area. MPD patients are always companied with underlying mass or masses, and mostly it can be seen by mammography. We fond the immunohistochemistry always showed HER2 positive. The patients who are simple Paget's disease will get a good prognosis. The others who are complicated with any symptoms such as underlying mass or lymph node involved will get worse prognosis.