Is There A Surgery For Paget’s Disease of The Breast?

If you are diagnosed with Paget’s disease of the breast, you will most likely require surgery.1

Besides mastectomy being a traditional treatment of Paget’s disease, breast-conserving surgery aims to remove cancer while preserving healthy breast tissue.2,3

Surgical techniques remove the risk of underlying comorbidity and improve the quality of life.4

Paget’s disease of the nipple is an uncommon type of breast cancer that is often misdiagnosed for skin disorders. The disease starts on the nipple and occurs most often in women older than age 50. The symptoms of Paget’s disease occur only in one breast.

In very unusual instances, malignant tumor units within the epidermis infect through the cellar layer of the skin into the dermis. If you are diagnosed with Paget’s disease of the breast, you will most likely require surgery.

Is There A Surgery For Paget’s Disease of The Breast?

Clinical diagnosis of Paget’s disease of the breast shows a markedly different approach to treatment. Besides mastectomy being a traditional treatment of Paget’s disease, breast-conserving surgery aims to remove cancer while preserving healthy breast tissue.

Breast-Conserving Surgery – Removal Of Breast Cancer And Surrounding Tissues

The goal of breast-conserving surgery in Paget’s disease of the breast is the removal of enough tissues affected with malignancy however medical studies show that recurrent rates of this type are high. The location and grade of the tumor vary depending on the individual and their health condition therefore the number of tissues removed during surgery also varies.1

Breast-conserving surgery is of two categories:

Lumpectomy- This is a surgical procedure wherein only the cancerous cells and the surrounding tissue is removed without the removal of the entire organ. Lumpectomy is usually performed after radiation therapy. The procedure involves a curved incision followed by the natural curve of your breast. After surgery, you will be monitored for your heartbeat, body temperature, and blood pressure. Also, you will be provided with pain medications to help to heal faster and to avoid infections. Most discomforts disappear on its own or it may persist, but you adapt to it.

Partial mastectomy- This is a more extensive procedure of removal of the area of the breast that contains cancer and some of the breast tissues around the melanoma. You will be able to resume normal activities in less than 3 weeks times. However, you should still avoid heavy-lifting and exercise for another 2-3 weeks. Some patients may experience pain and sensitivity after surgery, but this may resolve over time.2,3

Radiotherapy For Paget’s Disease of The Breast

Patients who have undergone breast-conserving surgery will require radiation therapy to the breast to treat Paget’s disease of the breast. A systematic search of the bibliographic databases PubMed and Scopus have proven evidence that radiation therapy followed by surgery reduces the risk of cancer coming back.

A study was conducted on 28 patients suffering from Paget’s disease of the breast who were treated with radiation therapy alone. Out of the 28 patients, 16 patients had no underlying factor and was found to be mammographically normal at the time of original treatment. Follow-up care was done over 5 years and 3 months and these patients remained free of disease therefore radical radiotherapy was considered as an effective alternative to mastectomy.

Complications of the surgery include bleeding, poor wound healing, and infection, or a sensitive reaction to the anesthesia used during the surgery. When you don’t want to have radiation therapy, breast-conserving surgery is not regarded as the right choice.4

References:

  1. “Paget’s Disease of the Breast.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 8 Mar. 2019, www.mayoclinic.org/diseases-conditions/pagets-disease-of-the-breast/diagnosis-treatment/drc-20351084.
  2. “Paget’s Disease of the Breast.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 8 Mar. 2019, www.mayoclinic.org/diseases-conditions/pagets-disease-of-the-breast/diagnosis-treatment/drc-20351084.
  3. “Surgery for Paget’s Disease.” Breastcancer.org, 23 June 2016, www.breastcancer.org/symptoms/types/pagets/surgery.
  4. Wu, Qi, et al. “Surgical Treatment in Paget’s Disease with Invasive Ductal Carcinoma: an Observational Study Based on SEER.” Nature News, Nature Publishing Group, 19 Apr. 2017, www.nature.com/articles/srep45510.

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