Paget’s disease, or DPM, is a rare type of breast disorder that is usually associated with other types of breast cancer. This disease is rare in women before age 40, most often diagnosed between the ages of 50 and 60. Although rare, Paget’s breast disease can also occur in humans.
The diagnosis of Paget’s disease of the breast is made by the mastologist through diagnostic tests and an evaluation of symptoms, such as nipple pain, local irritation and flaking, and nipple pain and itching.
- Symptoms of Paget’s disease usually appear in a single breast and are more common in women over the age of 50.
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In more advanced cases of Paget’s disease, there may be skin damage around the areola, as well as nipple retraction, reversal and ulceration, so it is important that treatment is started as soon as possible.
The most appropriate doctor to diagnose and guide treatment of Paget’s breast disease is the mastologist, but the dermatologist and gynecologist may also recommend identification and treatment of the disease. It is important that the diagnosis is made as soon as possible, because it can be treated correctly, with good results.
Paget’s condition is diagnosed by your doctor by evaluating the symptoms and characteristics of a woman’s breast, as well as imaging tests such as breast ultrasound and MRI, for example. In addition, mammography is also indicated for breast lumps or microcalcifications that may be a sign of invasive carcinoma.
In addition to imaging tests, your doctor often requests a nipple biopsy to check the characteristics of your cells, as well as an immunohistochemical test, which corresponds to a type of laboratory test that checks for the presence or absence of antigens. that can characterize the disease, such as AE1, AE3, CEA and EMA that are positive in Paget’s disease of the breast.
The differential diagnosis of Paget’s disease of breast is mainly in psoriasis, basal cell carcinoma and eczema for example, differing from the latter by being unilateral and with less intense itching. A differential diagnosis can also be made taking into account the response to treatment, since in Paget’s disease topical treatment can relieve symptoms but does not have a definitive effect, with relapse.
In addition, Paget’s disease of the breast, when pigmented, must be differentiated from melanoma, and this occurs mainly through histopathological examination, which is performed to evaluate breast cells, and immunohistochemistry, in which the presence of HMB-45 antigens, MelanA is found. and S100 in melanoma and the absence of antigens AE1, AE3, CEA and EMA, which are normally present in Paget’s disease.
Your doctor’s treatment for Paget’s disease of the breast is usually a mastectomy followed by chemotherapy or radiation therapy, as this disease is usually related to invasive carcinoma. In less extensive cases, surgical removal of the injured area may be indicated, preserving the rest of the breast. Early diagnosis is important to prevent not only disease progression, but also surgical treatment.
In some cases, your doctor may choose to perform treatment even without confirmation of diagnosis, indicating the use of topical medications. The problem with this type of behavior is that these medications can relieve symptoms, but they don’t prevent the disease from progressing.