Purpose Mammary Paget disease of the breast is rare form of breast
cancer. Recent trends in the management have changed from mastectomy to
breast conserving surgery, its safety is still controversial. The study
aimed to predict the patients prone to local recurrence, and to find out
the answer to the question of who should be a candidate for breast
conserving surgery. Methods Between January 2007 and December 2017, 69
patients who underwent surgery and pathology report diagnosed as Paget’s
disease, were analyzed retrospectively. As factors that may affect local
recurrence; age, presence of nipple symptoms, mass detection in
radiological imaging, type of the surgery, stage, pathological findings
of the tumor (histological type, multicentricity, ER, PR, HER2, Ki 67
proliferative index, molecular subtype) were evaluated. Results Among 69
patients, 26 patients had ductal carcinoma in situ and others had
invasive ductal carcinoma. Number of the patients underwent breast
conserving surgery and mastectomy was 15 and 54 respectively. Patients
were followed-up for a median time of 45 months. Recurrence was
developed in 12 patients, half of them with local recurrence. Type of
the surgery was the unique factor influencing local recurrence
(p=0.001). Subgroup analysis was performed among patients undergoing
breast conserving surgery, only Ki 67 proliferative index above 30
(p=0.002) was found to affect local recurrence. Conclusion Although the
number of patients is small, it should be kept in mind that local
recurrence may be high when BCS is performed in patients with the
tumor’s Ki 67 proliferative index is above 30.
Paget’s Disease of the Breast Presenting as a Local Recurrence Following Breast-conserving Surgery
