e17577 Background: Invasive extramammary Paget’s disease is most commonly in the vulva but can also occur in other genitalia as well as primary skin locations (face, scalp, neck, trunk, extremities). We aim to determine the clinicopathologic and prognostic factors of invasive Paget’s disease of the breast, genitalia and skin. Methods: Data on patients with invasive Paget’s disease of the breast, genitalia and skin were collected between 2001 and 2015 from the National Cancer Data Base Participant Use File 2016. Univariate, multivariate analyses, and Kaplan-Meier survival analysis were performed by SAS. Results: 10, 122 female patients were eligible, of which 7, 051 had invasive disease (breast n = 5, 105, genitalia n = 1, 717, skin n = 229) and the remainder had in situ disease. Median age for invasive disease was 63 years for breast, 73 years for genitalia and 75 years for skin. Among Whites, the proportion of invasive Paget’s of breast, genitalia, and skin was 70.8%, 25.8%, 3.4%; Blacks 93.8% breast, 5.3% genitalia and 0.9% skin; Asian/Pacific Islanders 65.0% breast, 31.8% genitalia and 3.2% skin. Among treatment institutions, academic centers treated 30.2% of invasive breast, 48.9% genitalia and 51.5% skin. Surgery was performed in 89.4% of invasive breast compared to 21.1% genitalia and 46.7% skin. Radiotherapy was administered to 25.3% of invasive breast, 3.0% genitalia and 15.3% skin. Chemotherapy was given to 28.0% of breast, 1.9% genitalia and 5.7% skin. Early stage (I or II) disease was diagnosed in 70.8% of invasive breast, 63% genitalia and 30.6% skin. Five-year OS from any cause for patients with invasive Paget’s disease of breast, genitalia and skin was 81.9%, 83.8%, and 69.9%, respectively. In univariate analysis, older age (HR 3.75, 95% CI 3.27-4.31, p < 0.001), Black race (HR 1.21, 95% CI 1.00-1.46, p = 0.046), history of other cancer (HR 1.53, 95%CI 1.36-1.71, p < 0.001), higher comorbidity score (HR 2.12, 95%CI 1.88-2.39, p < 0.001), higher stage (HR 4.25, 95%CI 3.73-4.85, p < 0.001), and no surgical treatment (HR 3.47, 95% CI 2.87-4.19, p < 0.001) were associated with worse survival. In multivariate analysis, invasive Paget’s of the skin was associated with the worst survival (HR 1.56, 95% CI 1.19-2.05, p = 0.001). For all three types of invasive Paget’s disease, better prognosis was associated with Asian/Pacific Islander race (HR 0.49, 95% CI 0.31-0.80, p = 0.004), income ≥ $63, 000 (HR 0.83, 0.70-0.98, p = 0.028) and treatment at an academic/research center (HR 0.78, 0.62-0.99, p = 0.037). Conclusions: Invasive Paget’s disease of the breast is 3-fold more common than genitalia with younger age at diagnosis. Most are diagnosed at early stages with good prognosis. Blacks have a higher proportion of invasive Paget’s disease of the breast than other races. Invasive Paget’s disease of primary skin had the poorest prognosis.