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\f0\fs24 \cf0 >>> DR.
JAY K. HARNESS: \f1 \expnd0\expndtw0\kerning0
\expnd0\expndtw0\kerning0 In 1874, Sir James Paget described Pagets
disease of the breast.
Now, what is Pagets disease of the breast?
Why is it such a rare form of breast cancer?
How would I, as a patient, potentially recognize Pagets?
Is Pagets often misdiagnosed for eczema, as an example, of the nipple areolar area?
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\cf0 \ We are trying to keep the definitions non-medical
here and pretty straightforward and pretty simple if I can.
Paget\'92s disease of the breast makes up only about one to little over four percent
of all breast cancers.
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When you look at the nipple, or the nipple and the areola, to the eye it does look like
eczema, and what\'92s happening is that cancer cells are coming up and getting into and growing
into the surface \'96 the epithelium, if you will, covering the nipple, giving that kind
of scaling effect, that kind of heartbreak, if you will, of eczema.
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Quite frankly, through the years, I have lost track of the number of patients I have seen
with Pagets disease of the breast whose primary care physicians initially treated them with
topical steroids thinking that this was eczema of the breast.
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Could it be?
Yeah, it\'92s part of the differential, but far more important, if you have changes like
that of either the nipple and/or the areola, the very first thing that needs to be done
is your breast needs to be seen and evaluated by a breast surgeon.
You need imaging studies including mammograms and ultrasound and possibly even MRI.
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Making the diagnosis is pretty simple.
You can do a little punch biopsy like dermatologists do, of the skin of the nipple, and theres
certain Pagetoid cells that make it straight forward for the pathologist to make the diagnosis.
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Now typically, theres an underlying cancer, underneath the nipple areolar complex.
It can be downstream, if you will, and the cancers come up the ductal system into the
nipple and so we often see Pagets associated with either in situ breast cancer or invasive
breast cancer.
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There are times, but not a lot, where we can actually find the source underneath the nipple
areolar complex and particularly now with breast MRI, we should almost always be able
to find the source.
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Well what about the treatment?
The treatment of Pagets is basically like an in situ cancer, if that\'92s what it\'92s
associated with, down deeper in the breast.
Unfortunately, the nipple and areola typically need to be removed as well as obviously treating
the underlying cancer.
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So, there are lots of variations to Pagets disease of the breast and I don\'92t want
to try and get into all those variations now.
Pagets is an unusual form of breast cancer.
It is treated in a very straightforward way by multidisciplinary centers.
You need the appropriate imaging studies to figure out what\'92s going on underneath the
nipple area.
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And the bottom line for our viewers is that if you or you know someone that has what you
believe looks like eczema of either to the nipple areolar area, you need an evaluation
right away.
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\cf0 \expnd0\expndtw0\kerning0 \
Susan Denver: I am a breast cancer survivor.
\ \
Katherine Stockton: I am a breast cancer survivor.
\ \
Coree: I am a breast cancer survivor.
\ \
Susan Denver: And I want every woman to know\'85 \
\ Katherine Stockton: \'85about personalized
breast cancer treatment\'85 \ \
Susan Denver: \'85and the Genomic Test.
\ \
Coree: A test that helps guide a woman and her doctor\'85 \
\ Katherine Stockton: \'85to the best treatment
options for her.
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Susan Denver: Pass it on! }