Paget's Disease Occurred 8 Years after Breast- Conserving Surgery for Ductal Carcinoma in Situ (DCIS) of the Breast

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  • 乳房温存術8年後に発症したPaget病の1例
  • 症例 乳房温存術8年後に発症したPaget病の1例
  • ショウレイ チブサ オンゾンジュツ 8ネンゴ ニ ハッショウ シタ Pagetビョウ ノ 1レイ

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We herein report a case of Paget's disease occurred 8 years after breast-conserving surgery and axillary dissection followed by radiotherapy for ductal carcinoma in situ (DCIS) of the breast when she was 47 years old. Eight years later, she presented with erosion of the nipple. Mastectomy was performed with a diagnosis of Paget's disease. Histologically, Paget cells were confined to the epidermis of the nipple and areola without intraductal spread. DCIS and Paget's disease were compared using immunohistochemistry. Both tumor cells were weakly positive for CK5/6 and CK14, 17 and markedly positive for CK18, CK7 and EMA. ER and PgR were negative and AR positive in tumor cells of both types. Both tumor cells were markedly positive for HER-2 and P53. Ki67 labeling index in DCIS was 4% versus 14% in Paget's disease. Immunoprofiles of DCIS and Paget's disease were the same except for higher Ki67 labeling index in the latter. These results, however, still could not discern whether Paget's disease in this particular case could represent the recurrence of DCIS or de novo disease.

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