Mammary Paget's disease. Clinical Case

Abstract

Introduction: Paget's disease of the breast (PMD) is a peculiar form of cancer determined by eczematous changes and ulceration in the nipple and/or areola. Its occurrence is low, it is misinterpreted by other dermatological lesions, hindering its diagnosis, increasing its dissemination and delaying its therapeutic management. The objective is to publicize the clinical appearance of EPM through the presentation of a real case to prevent serious complications. Presentation of the case: A 56-year-old female patient reports that five months ago, approximately, she presented an erythematous area on the right breast with no apparent cause, for which she went to the doctor where she was diagnosed and treated for mycosis. A month ago, the lesion increases in size, accompanied by itching, redness and pain. As there was no improvement, she went to our nursing home; A sample was taken for incisional biopsy, reporting consistent with EPM. She was transferred to the oncological surgery service, where a surgical plan was carried out that consisted of a segmentectomy of the right breast plus an intraoperative study (ETO) of the edges for an immunohistochemical study and establishment of treatment according to the patient. Conclusion: It is an atypical disease, in one or both breasts, affecting the nipple-areola complex, for the diagnosis physical examination and clinical tests are required; in the treatment, results of the tumor tests must be obtained to detect the expression of hormone receptors and the overexpression of HER2. In addition to being prognostic, it can be used to design individualized adjuvant therapy plans.