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The pathogenesis of mammary Paget disease and the origin of Paget jail cell were once controversial . It is now wide accepted that mammary Paget disease is always associated with an implicit in carcinoma of the breast.(1 )
By thorough histological examination , Muir document intraepidermal extension phone of malignant ductal epithelial cells through the lactiferous duct and ductule into the epidermis ( epidermotropism).(1 )
Mammary PD happen almost alone in cleaning lady ; involvement of the manlike bosom is rarely reported and may be more aggressive.(1 )
Is Paget’s Disease Of The Breast Progressive?
Paget ’s disease of the breast is reformist because at first it is found only at the microscopical level and then goes on rising which may eventually even demand the whole of the knocker open . As Muir ( a diagnostician ) has determined by a histologic exam that the cells found in the Paget ’s disease of the breast belong to the malignant breast tumor which journey by the lactiferous duct into the epidermis . This phenomenon is also know as epidermotropism because cells of the malignant boob tumor are attracted to the cuticle which leads to the campaign of those cells towards the breast surface .
It presents as an erythematous , eczematous skin wound with crustation and scale formation on the breast surface unremarkably need the area around the tit , hence the name Paget ’s disease of the nipple . Cells found in Paget ’s disease are do it to be positivist for ‘ her to neu ’ receptor which is a very common entity found in association withbreast cancer .
ab initio , it travel via one or few lactiferous ducts and present as a minuscule erythematous domain on the breast surface but soon it can take multiple lactiferous duct and even the whole of the breast country can be converted into crustaceous and scaly wound . Its progression also speaks about the progression of malignant neoplastic disease within the breast .
Alternative Treatments For Paget’s Disease Of The Breast
operative treatment is the lynchpin of discourse in this status because it is almost 100 % associated with the underlie breast cancer.(2)Mastectomy meaning the remotion of breast tissue is the mainstay of treatment which could be modified or radical depending upon the size of cancerous tissue paper in the breast . Lymph node removal from the surround lymph client groups depending upon the sentinel biopsy and palpable lymph leaf node has also to be done to prevent its bed cover from becoming metastatic cancer .
In face there is no palpable stack in the breast even in the bearing of Paget ’s disease of nipple / boob and the lesion is of smaller diam then the bourgeois form of treatment can be approached . In this , the whole of the breast tissue is not remove but only a part can be removed such as by hacek resection , quadrantectomy , cone resection , local excision , etc .
Conclusion
There is no doubt about the fact that Paget ’s disease of the titty which is also sometimes referred as Paget ’s disease of the nipple is a reform-minded disease which take up by small-scale erythematous area on the boob surface around the mammilla and may involve whole of the knocker airfoil with crusty and scaly wound in later stages .
Earlier it was consider to be a separate disease but now it has been found that it is almost a hundred per centum associated with underlying palpable mass which may be any character of breast Cancer the Crab so it has to be treated invariably and as early as possible .
Surgical form of treatment is very effective with a radical approach to complete the whole mastectomy but sometimes depend upon the size of it of the lesion , a bourgeois treatment glide path can also be followed . Laser treatment has also been used with considerable winner to completely cure this condition .
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