<prompt> True statements regarding Pagets disease of the breast include that itUsually precedes development of Pagets disease of bonePresents with nipple-areolar eczematous changesDoes not involve axillary lymph nodes because it is a manifestation of intraductal carcinoma onlyAccounts for 10-15 of all newly diagnosed breast cancers  <response>: Pagets disease of the breast is unrelated to Pagets bone disease. It represents a small percentage 1-3 of all breast cancers and is thought to originate in the retro areolar lactiferous ducts. It progresses toward the nipple-areola complex in most patients, where it causes the typical clinical finding of nipple eczema and erosion. Up to 20 of patients with Pagets disease have an associated breast mass, and these patients are more likely to have involvement of axillary nodes. Nipple-areolar disease alone usually represents in situ cancer; these patients have a 10-year survival rate of over 80. In contrast, if Pagets disease presents with a mass, the mass is likely to be an infiltrating ductal carcinoma. The generally recommended surgical procedure for Pagets disease is currently a modified radical mastectomy. The validity of breast-saving surgery and adjuvant radiation therapy for patients without an associated mass is under investigation. 