Paget's disease of the breast natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Preeti Singh, M.B.B.S.[2]
Overview
The prognosis for people with Paget's disease of the breast is primarily determined by the underlying tumor. Unfavorable prognosis is seen in cases with palpable breast tumor, enlarged lymph nodesand in patients younger than 60 years of age. Prognosis is worse in males than in females. Mean survival was found to be 80.0 months for males and 108.2 months for females. Five-year survival rate has been reported to be 20-30% in males, compared to 30-40% in females. This has been hypothesized to be due to the small size of mammary gland in males.
Prognosis
- The prognosis for people with Paget's disease of the breast depends on a variety of factors, and is primarily determined by the underlying tumor.
- Some factors indicate an unfavorable prognosis, such as:[1][2]
- Presence of palpable breast tumor
- Enlarged lymph nodes
- Histological type of breast cancer
- Patients younger than 60 years
Survival rates
- In patients with Paget's disease of the breast mean survival was found to be 80.0 months for males and 108.2 months for females.
- Five-year survival rate has been reported to be 20-30% in males, compared to 30-40% in females. This has been hypothesized to be due to the small size of mammary gland in males.[3][4]
- The presence of invasive cancer in the affected breast and the spread of cancer to nearby lymph nodes are associated with reduced survival.
- Lymph node involvement is correlated with median survival rates, reaching 75-95% when negative and 20 to 25% when positive.
- In another study, the mean 10-year survival rate was estimated at 47% in cases with positive lymph nodes and 93% in those with negative lymph nodes.
- When the disease occurs in males, the prognosis is poor, with an average 5-year survival rate of 20-30%.
- Patients with Paget disease concomitant infiltrating duct carcinoma (PD‐IDC)had the worst prognosis with 5‐year survival rate = 84.1%.
- The Paget disease concomitant intraductal carcinoma (PD‐DCIS) had the best prognosis with 5‐year survival rate = 97.5%.
- Among patients with Paget disease those who are married have a better prognosis than who were not.
- Marital status is said to be associated with the hormone receptor status in patients with PD‐IDC.[5][6]
References
- ↑ Lopes Filho, Lauro Lourival; Lopes, Ione Maria Ribeiro Soares; Lopes, Lauro Rodolpho Soares; Enokihara, Milvia M. S. S.; Michalany, Alexandre Osores; Matsunaga, Nobuo (2015). "Mammary and extramammary Paget's disease". Anais Brasileiros de Dermatologia. 90 (2): 225–231. doi:10.1590/abd1806-4841.20153189. ISSN 1806-4841.
- ↑ Paget's disease of the breast. National cancer institute. http://www.cancer.gov/types/breast/paget-breast-fact-sheet
- ↑ . doi:10.1001/ archdermatol.2008.508. Check
|doi=value (help). Missing or empty|title=(help) - ↑ Leibou L, Herman O, Frand J, Kramer E, Mordechai S (January 2015). "Paget's disease of the male breast with underlying ductal carcinoma in situ". Isr. Med. Assoc. J. 17 (1): 64–5. PMID 25739183.
- ↑ Zhao Y, Sun HF, Chen MT, Gao SP, Li LD, Jiang HL, Jin W (June 2018). "Clinicopathological characteristics and survival outcomes in Paget disease: a SEER population-based study". Cancer Med. 7 (6): 2307–2318. doi:10.1002/cam4.1475. PMC 6010794. PMID 29722170.
- ↑ Zhou H, Lu K, Zheng L, Guo L, Gao Y, Miao X, Chen Z, Wang X (2018). "Prognostic significance of mammary Paget's disease in Chinese women: a 10-year, population-based, matched cohort study". Onco Targets Ther. 11: 8319–8326. doi:10.2147/OTT.S171710. PMC 6260180. PMID 30538501.