Abstract |
Herein, we report a rare case of invasive Paget disease of the nipple with axillary- lymph-node metastasis in a 60-year-old white woman. The patient had intermittent, bloody nipple discharge without skin changes of the nipple-areolar region. We considered the clinical diagnosis of intraductal papilloma. A subareolar core biopsy revealed invasive ductal carcinoma in deep dermal tissue without the overlying epidermis biopsied. The patient underwent total mastectomy and axillary sentinel lymph-node biopsy that demonstrated invasive Paget disease of the nipple with 3.5-mm depth of invasion, ductal carcinoma in-situ in the underlying breast parenchyma, and macrometastasis (5.0 mm) in the sentinel lymph node. Prognostic marker studies of the metastatic site revealed a profile similar to that in the invasive mammary Paget disease ( estrogen receptor [ER]+/ progesterone receptor [PR]+/ human epidermal growth factor receptor 2 [HER2]-/proliferation index [Ki-67] of 30%). The patient received adjuvant chemotherapy and experienced no disease recurrence at 20-months of follow-up. This case of luminal-B subtype invasive Paget disease as the source of regional metastasis is unique in the literature, to our knowledge.
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Authors | Karan Saluja, Sunati Sahoo |
Journal | Laboratory medicine
(Lab Med)
Vol. 46
Issue 4
Pg. 332-7
( 2015)
ISSN: 1943-7730 [Electronic] England |
PMID | 26489679
(Publication Type: Case Reports, Journal Article)
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Copyright | Copyright© by the American Society for Clinical Pathology (ASCP). |
Topics |
- Breast Neoplasms
- Female
- Humans
- Lymph Nodes
(pathology)
- Middle Aged
- Nipples
(pathology)
- Paget's Disease, Mammary
- Sentinel Lymph Node Biopsy
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