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What is Paget's disease of the nipple is treated by and explain in detail?
Ans. is 'c' i.e., Biopsy and Simple mastectomy Paget's 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). The underlying lesion may be palpable or not. A complete mammographic workup and biopsy of the nipple and underlying mass if present is done. Pathognomonic histological feature is presence of Paget's cells in the epithelium. A skin specimen containing cells confirms the diagnosis and can be obtained by nipple scrape cytology or biopsy. Paget's 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 Paget's disease. Treatment of Paget's disease includes : - mastectomy + axillary staging (axillary dissection or sentinel node biopsy) wide excision of the nipple and areola to achieve clear margins + radiation + axillary staging, or lumpectomy + radiation therapy + axillary lymph node procedure