Paget disease of the breast

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Summary of Paget disease of the breast

Paget's disease of the breast is a malignant, noninvasive breast cancer variant that may result from underlying ductal carcinoma in situ or invasive breast cancer. It almost always signifies an underlying cancer, and usually presents with eczematous skin changes around the nipple region. Inflammatory breast cancer is an important differential diagnosis. Paget disease demonstrates Paget cells (intraepithelial adenocarcinoma cells) on histology.

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Paget disease of the breast

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Paget disease of the breast

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A 65-year-old woman comes to the clinic for a breast biopsy of an abnormal lesion noted on mammogram. Her mammogram showed bilateral small nodules within the breast tissue. Physical examination does not show any palpable mass and there are no skin changes or lymphadenopathy. A biopsy of one of these abnormal nodules shows small cells that are arranged in a single line invading the normal breast stroma. The cells do not stain with E-cadherin. Which of the following is the most likely diagnosis?

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