Mammary Paget's Disease of the Nipple: A Case Report.

Abstract

Introduction: Tumors of the nipple-areolar complex are relatively uncommon, and Paget's disease is an uncommon presentation involving epidermal invasion of the nipple by a carcinoma in situ. Mammary Paget's disease (MPD) presents a diagnostic challenge, especially in the absence of a palpable breast mass, which often leads to delayed diagnosis and treatment.

Case report: We present the case of a 64-year-old woman with persistent skin erosion of the left nipple that was unresponsive to multiple topical treatments. Diagnostic evaluation, including mammography and MRI, revealed no invasive malignancy. Nipple biopsy confirmed MPD with underlying in situ ductal carcinoma. The patient underwent lumpectomy with removal of the nipple-areolar complex, followed by radiotherapy, resulting in a favorable outcome.

Discussion: Diagnosis of MPD can be challenging because of its resemblance to benign dermatological conditions. Imaging, particularly mammography and MRI, is essential for assessing the underlying malignancy and surgical planning. Treatment typically involves surgical excision, with breast-conserving therapy considered for localized disease. Early detection significantly improves the prognosis, particularly in the absence of invasive cancer.

Conclusion: MPD should be considered in patients with persistent eczematous nipple lesions resistant to topical treatments. Early diagnosis and appropriate surgical management are crucial to achieve favorable outcomes.