Paget's disease of the nipple with parenchymal ductal carcinoma in situ is associated with worse prognosis than Paget's disease alone
Paget's disease of the nipple is often found in conjunction with underlying ductal carcinoma in situ (DCIS). In isolation, Paget's disease of the nipple, like DCIS, confers an excellent prognosis for survival. Our objective was to determine if Paget's disease identified with synchrono...
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| Veröffentlicht in: | The American surgeon 2013-10, Vol.79 (10), p.1009-1012 |
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| creator | Durkan, Brandice Bresee, Catherine Bose, Shikha Phillips, Edward H Dang, Catherine M |
| description | Paget's disease of the nipple is often found in conjunction with underlying ductal carcinoma in situ (DCIS). In isolation, Paget's disease of the nipple, like DCIS, confers an excellent prognosis for survival. Our objective was to determine if Paget's disease identified with synchronous parenchymal DCIS has as favorable an outcome as Paget's disease alone. We analyzed a prospectively maintained pathology database and medical records to identify all patients diagnosed with Paget's disease of the nipple between June 1996 and December 2011. Overall survival was analyzed using Kaplan-Maier statistics and Cox proportional hazards modeling. Seventy-four patients were identified with Paget's disease: five (6%) with isolated Paget's of the nipple, 22 (30%) associated with parenchymal DCIS, and 47 (64%) associated with invasive cancer (± DCIS). Unexpectedly, patients with Paget's disease and DCIS had a worse prognosis than those with Paget's disease alone. Survival correlated with pathologic stage at diagnosis. Among the 16 deaths, median survival was 2.8 years (range, 0.1 to 15.2 years). Median follow-up for the entire cohort was 4.2 years (range, 0.1 to 15.2 years). Thus, Paget's disease with parenchymal DCIS may confer worse survival than isolated Paget's disease of the nipple, suggesting the difficulty of identifying invasive carcinoma within a background of DCIS. |
| doi_str_mv | 10.1177/000313481307901011 |
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In isolation, Paget's disease of the nipple, like DCIS, confers an excellent prognosis for survival. Our objective was to determine if Paget's disease identified with synchronous parenchymal DCIS has as favorable an outcome as Paget's disease alone. We analyzed a prospectively maintained pathology database and medical records to identify all patients diagnosed with Paget's disease of the nipple between June 1996 and December 2011. Overall survival was analyzed using Kaplan-Maier statistics and Cox proportional hazards modeling. Seventy-four patients were identified with Paget's disease: five (6%) with isolated Paget's of the nipple, 22 (30%) associated with parenchymal DCIS, and 47 (64%) associated with invasive cancer (± DCIS). Unexpectedly, patients with Paget's disease and DCIS had a worse prognosis than those with Paget's disease alone. Survival correlated with pathologic stage at diagnosis. Among the 16 deaths, median survival was 2.8 years (range, 0.1 to 15.2 years). Median follow-up for the entire cohort was 4.2 years (range, 0.1 to 15.2 years). Thus, Paget's disease with parenchymal DCIS may confer worse survival than isolated Paget's disease of the nipple, suggesting the difficulty of identifying invasive carcinoma within a background of DCIS.</description><identifier>ISSN: 0003-1348</identifier><identifier>EISSN: 1555-9823</identifier><identifier>DOI: 10.1177/000313481307901011</identifier><identifier>PMID: 24160789</identifier><language>eng</language><publisher>United States: SAGE PUBLICATIONS, INC</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Breast cancer ; Breast Neoplasms - diagnosis ; Breast Neoplasms - mortality ; Breast Neoplasms - surgery ; Breasts ; Carcinoma, Intraductal, Noninfiltrating - diagnosis ; Carcinoma, Intraductal, Noninfiltrating - mortality ; Carcinoma, Intraductal, Noninfiltrating - surgery ; Chemotherapy ; Databases, Factual ; Female ; Follow-Up Studies ; Humans ; Mammography ; Mastectomy ; Middle Aged ; Neoplasms, Multiple Primary - diagnosis ; Neoplasms, Multiple Primary - mortality ; Neoplasms, Multiple Primary - surgery ; Nipples ; Paget's Disease, Mammary - diagnosis ; Paget's Disease, Mammary - mortality ; Paget's Disease, Mammary - surgery ; Prognosis ; Retrospective Studies ; Survival Analysis ; Womens health</subject><ispartof>The American surgeon, 2013-10, Vol.79 (10), p.1009-1012</ispartof><rights>Copyright Southeastern Surgical Congress Oct 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-77b24bf49eb9690488e30be5871157950f396bcb914b764461eae69c543429b73</citedby><cites>FETCH-LOGICAL-c375t-77b24bf49eb9690488e30be5871157950f396bcb914b764461eae69c543429b73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24160789$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Durkan, Brandice</creatorcontrib><creatorcontrib>Bresee, Catherine</creatorcontrib><creatorcontrib>Bose, Shikha</creatorcontrib><creatorcontrib>Phillips, Edward H</creatorcontrib><creatorcontrib>Dang, Catherine M</creatorcontrib><title>Paget's disease of the nipple with parenchymal ductal carcinoma in situ is associated with worse prognosis than Paget's disease alone</title><title>The American surgeon</title><addtitle>Am Surg</addtitle><description>Paget's disease of the nipple is often found in conjunction with underlying ductal carcinoma in situ (DCIS). In isolation, Paget's disease of the nipple, like DCIS, confers an excellent prognosis for survival. Our objective was to determine if Paget's disease identified with synchronous parenchymal DCIS has as favorable an outcome as Paget's disease alone. We analyzed a prospectively maintained pathology database and medical records to identify all patients diagnosed with Paget's disease of the nipple between June 1996 and December 2011. Overall survival was analyzed using Kaplan-Maier statistics and Cox proportional hazards modeling. Seventy-four patients were identified with Paget's disease: five (6%) with isolated Paget's of the nipple, 22 (30%) associated with parenchymal DCIS, and 47 (64%) associated with invasive cancer (± DCIS). Unexpectedly, patients with Paget's disease and DCIS had a worse prognosis than those with Paget's disease alone. Survival correlated with pathologic stage at diagnosis. Among the 16 deaths, median survival was 2.8 years (range, 0.1 to 15.2 years). Median follow-up for the entire cohort was 4.2 years (range, 0.1 to 15.2 years). Thus, Paget's disease with parenchymal DCIS may confer worse survival than isolated Paget's disease of the nipple, suggesting the difficulty of identifying invasive carcinoma within a background of DCIS.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - diagnosis</subject><subject>Breast Neoplasms - mortality</subject><subject>Breast Neoplasms - surgery</subject><subject>Breasts</subject><subject>Carcinoma, Intraductal, Noninfiltrating - diagnosis</subject><subject>Carcinoma, Intraductal, Noninfiltrating - mortality</subject><subject>Carcinoma, Intraductal, Noninfiltrating - surgery</subject><subject>Chemotherapy</subject><subject>Databases, Factual</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Mammography</subject><subject>Mastectomy</subject><subject>Middle Aged</subject><subject>Neoplasms, Multiple Primary - diagnosis</subject><subject>Neoplasms, Multiple Primary - mortality</subject><subject>Neoplasms, Multiple Primary - surgery</subject><subject>Nipples</subject><subject>Paget's Disease, Mammary - diagnosis</subject><subject>Paget's Disease, Mammary - mortality</subject><subject>Paget's Disease, Mammary - surgery</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Survival Analysis</subject><subject>Womens health</subject><issn>0003-1348</issn><issn>1555-9823</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNplkcFq3DAQhkVpaTZpXyCHIuihubjRWJJlHUtom0AgPTRnI2nHWQVbciWZkAfoe1fLJj0kp0Ho-78Z-Ak5BfYVQKlzxhgHLnrgTGkGDOAN2YCUstF9y9-SzR5o9sQROc75vj5FJ-E9OWoFdEz1ekP-_jJ3WL5kuvUZTUYaR1p2SINflgnpgy87upiEwe0eZzPR7epKHc4k50OcDfWBZl9W6jM1OUfnTcHtIfcQUxUuKd6FmOt_2ZlAX-4zUwz4gbwbzZTx49M8Ibc_vv--uGyub35eXXy7bhxXsjRK2VbYUWi0utNM9D1yZlH2CkAqLdnIdWed1SCs6oToAA122knBRaut4ifk7OCtR_1ZMZdh9tnhNJmAcc0D1EyVaa0r-vkFeh_XFOp1lZKs7erGvbA9UC7FnBOOw5L8bNLjAGzYlzS8LqmGPj2pVzvj9n_kuRX-Dw8ii_4</recordid><startdate>201310</startdate><enddate>201310</enddate><creator>Durkan, Brandice</creator><creator>Bresee, Catherine</creator><creator>Bose, Shikha</creator><creator>Phillips, Edward H</creator><creator>Dang, Catherine M</creator><general>SAGE PUBLICATIONS, INC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>4U-</scope><scope>7QL</scope><scope>7RV</scope><scope>7T7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>201310</creationdate><title>Paget's disease of the nipple with parenchymal ductal carcinoma in situ is associated with worse prognosis than Paget's disease alone</title><author>Durkan, Brandice ; Bresee, Catherine ; Bose, Shikha ; Phillips, Edward H ; Dang, Catherine M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-77b24bf49eb9690488e30be5871157950f396bcb914b764461eae69c543429b73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - 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Academic</collection><jtitle>The American surgeon</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Durkan, Brandice</au><au>Bresee, Catherine</au><au>Bose, Shikha</au><au>Phillips, Edward H</au><au>Dang, Catherine M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Paget's disease of the nipple with parenchymal ductal carcinoma in situ is associated with worse prognosis than Paget's disease alone</atitle><jtitle>The American surgeon</jtitle><addtitle>Am Surg</addtitle><date>2013-10</date><risdate>2013</risdate><volume>79</volume><issue>10</issue><spage>1009</spage><epage>1012</epage><pages>1009-1012</pages><issn>0003-1348</issn><eissn>1555-9823</eissn><abstract>Paget's disease of the nipple is often found in conjunction with underlying ductal carcinoma in situ (DCIS). In isolation, Paget's disease of the nipple, like DCIS, confers an excellent prognosis for survival. Our objective was to determine if Paget's disease identified with synchronous parenchymal DCIS has as favorable an outcome as Paget's disease alone. We analyzed a prospectively maintained pathology database and medical records to identify all patients diagnosed with Paget's disease of the nipple between June 1996 and December 2011. Overall survival was analyzed using Kaplan-Maier statistics and Cox proportional hazards modeling. Seventy-four patients were identified with Paget's disease: five (6%) with isolated Paget's of the nipple, 22 (30%) associated with parenchymal DCIS, and 47 (64%) associated with invasive cancer (± DCIS). Unexpectedly, patients with Paget's disease and DCIS had a worse prognosis than those with Paget's disease alone. Survival correlated with pathologic stage at diagnosis. Among the 16 deaths, median survival was 2.8 years (range, 0.1 to 15.2 years). Median follow-up for the entire cohort was 4.2 years (range, 0.1 to 15.2 years). Thus, Paget's disease with parenchymal DCIS may confer worse survival than isolated Paget's disease of the nipple, suggesting the difficulty of identifying invasive carcinoma within a background of DCIS.</abstract><cop>United States</cop><pub>SAGE PUBLICATIONS, INC</pub><pmid>24160789</pmid><doi>10.1177/000313481307901011</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Breast cancer Breast Neoplasms - diagnosis Breast Neoplasms - mortality Breast Neoplasms - surgery Breasts Carcinoma, Intraductal, Noninfiltrating - diagnosis Carcinoma, Intraductal, Noninfiltrating - mortality Carcinoma, Intraductal, Noninfiltrating - surgery Chemotherapy Databases, Factual Female Follow-Up Studies Humans Mammography Mastectomy Middle Aged Neoplasms, Multiple Primary - diagnosis Neoplasms, Multiple Primary - mortality Neoplasms, Multiple Primary - surgery Nipples Paget's Disease, Mammary - diagnosis Paget's Disease, Mammary - mortality Paget's Disease, Mammary - surgery Prognosis Retrospective Studies Survival Analysis Womens health |
| title | Paget's disease of the nipple with parenchymal ductal carcinoma in situ is associated with worse prognosis than Paget's disease alone |
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