Invasive paget disease of the nipple of luminal-B subtype with axillary lymph node metastasis in a 60-year-old white woman

Karan Saluja, Sunati Sahoo

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Herein, we report a rare case of invasive Paget disease of the nipple with axillary-lymph-node metastasis in a 60-year-old white woman. The patient had intermittent, bloody nipple discharge without skin changes of the nipple-areolar region. We considered the clinical diagnosis of intraductal papilloma. A subareolar core biopsy revealed invasive ductal carcinoma in deep dermal tissue without the overlying epidermis biopsied. The patient underwent total mastectomy and axillary sentinel lymph-node biopsy that demonstrated invasive Paget disease of the nipple with 3.5-mm depth of invasion, ductal carcinoma in-situ in the underlying breast parenchyma, and macrometastasis (5.0 mm) in the sentinel lymph node. Prognostic marker studies of the metastatic site revealed a profile similar to that in the invasive mammary Paget disease (estrogen receptor [ER]+/progesterone receptor [PR]+/ human epidermal growth factor receptor 2 [HER2]-/ proliferation index [Ki-67] of 30%). The patient received adjuvant chemotherapy and experienced no disease recurrence at 20-months of follow-up. This case of luminal-B subtype invasive Paget disease as the source of regional metastasis is unique in the literature, to our knowledge.

Original languageEnglish (US)
Pages (from-to)332-337
Number of pages6
JournalLaboratory Medicine
Volume46
Issue number4
DOIs
StatePublished - Nov 1 2015

Keywords

  • Breast
  • Carcinoma
  • Invasive
  • Mammary
  • Nipple
  • Paget disease

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical

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