<prompt> Surgery for breast carcinoma true is -Mastectomy superior to breast conservative surgeiyPagets disease of breast treated by wide excisionIt needs RT after Surgery in all StagesUsually bilateral  <response>: Ans. is b i.e., Pagets disease of breast treated by wide excisiono Pagets disease of nipple is a chronic eczematous eruption of nipple which may progress to an ulcerated weeping lesion. It is almost always associated with an underlying ductal carcinoma may be in situ Ca or invasive,o The underlying lesion may be palpable or not.o A complete mammographic workup and biopsy of the nipple and underlying mass if present is done,o Pathognomonic histological feature is presence of Pagets cells in the epithelium. A skin specimen containing cells confirms the diagnosis and can be obtained by nipple scrape cytology or biopsy.o Pagets disease may be confused with superficial spreading melanoma. Differentiation from pagetoid intraepithelial melanoma is based on the presence of S-100 antigen immunostaining in melanoma and carcinoembryonic antigen immunostaining in Pagets disease.Treatment of Pagets disease includes :Mastectomy axillary staging axillary dissection or sentinel node biopsyWide excision of the nipple and areola to achieve clear margins radiation axillary staging, orLumpectomy radiation therapy axillary lymph node procedureo Pagets disease of nipplePagets disease of the breast is a superficial manifestation of an underlying breast carcinoma.The underlying breast carcinoma is intraductal carcinoma.It presents clinically as a chronic eczematous eruption of nipple, which may be subtle but may progress to an ulcerated, weeping lesion.Pagets disease usually is associated with extensive DC1S and may be associated with an invasive cancer. The carcinoma may or may not be palpable.A complete mammographic workup and biopsy of the nipple and underlying mass if present is done.Pathognomonic histological feature is presence of Pagets cells in the epithelium. Pagets cells are large pale vacuolated cells. A skin specimen containing cells confirms the diagnosis and can be obtained by nipple scrape cytology or biopsy.There is no survival advantage for mastectomy over breast preservation . Sabiston 18,he p. 874 