Abstract
We report a case of Paget's disease of the nipple developed eight years after breast conserving treatment. The patient was a 52-year-old woman who had undergone breast conserving surgery and sentinel lymph node dissection for invasive ductal carcinoma with intraductal involvement of the right breast in February 2005. Postoperative chemotherapy and hormone therapy were performed, but radiotherapy was not done according to the patient's hope. No findings of recurrence had been seen until April 2013 when she noticed erosion of the mammary nipple and areola in the right remnant breast. Skin biopsy of the nipple revealed Paget cells. Right mastectomy for the remnant breast was performed with a preoperative diagnosis of Paget's disease. Histopathological study demonstrated Paget cells in the nipple epidermis and intraductal spread of cancer cells from just under the nipple lesion to the B area in the remnant right breast. The histopathological diagnosis was ductal carcinoma in situ with Paget's disease. We diagnosed the case as ipsilateral breast tumor recurrence from the extent of cancer cells.
Although this type of recurrence is a rare situation, we should suspect it if nipple changes appear after breast conserving treatment for early diagnosis and treatment.
