Clinicopathologic Features of Male Paget Disease of Breast: 11 Cases from a Single Institute
Xiuzhen Duan, Ashley Gullett, Nour Sneige, Daniel Rosen, Erika Resetkova, Cagatay Ersahin, Yun Wu, Isabelle Bedrosian, Constance T Albarracin. Loyola University Medical Center, Maywood, IL; MD Anderson Cancer Center, Houston, TX; University of Washington, Seattle, WA
Background: Mammary Paget disease (MPD) is an uncommon tumor consisting of 1-3% of total breast cancer. Male MPD is much rarer with only single case reports in the English literature. As a result there is not much information regarding the histopathologic and clinical features of this entity. This retrospective study was designed to examine and characterize the clinicopathologic features of male MPD.
Design: We searched our database from 1985 to 2010 at the Department of Pathology, M.D. Anderson Cancer Center and identified 11 cases of male MPD. We collected the following clinical information: presentation symptoms, methods of treatments, clinical follow up; and evaluated histopathologic features including diagnosis of breast cancer, tumor markers and lymph node status.
Results: Age of these patients at presentation ranged from 50 to 90 years (mean 62). Seven patients presented with either skin changes, nipple inversion or nipple discharge and three of them also had palpable masses. Remaining four patients presented with palpable masses only. All patients had underline breast cancers; two DCIS and nine invasive ductal carcinoma (IDC, six T1, one T2 and two T4). IHC studies demonstrated that the underlying breast tumors were positive for ER in all nine patients tested while only two of seven patients tested were positive for Her-2. Nine patients underwent modified total radical mastectomy with axalliry lymph node dissections (five patients) or sentinel node sampling (four patients). The other two patients were treated with single or bilateral simple total mastectomy with axillary node dissections. Four patients with IDC had metastatic disease in lymph nodes (two N1, one N2 and one N3) while lymph nodes in remainging patients were negative. Seven patients with IDC also underwent radiation, chemo- or hormonal therapy; including one radiation and hormonal; four chemo- and hormonal; one chemotherapy only and one hormonal therapy only. Remaining four patients (two IDC and two DCIS) had no further treatments. Follow-up time ranged from 1 month to 11 years. Six patients were alive without diseases and one was alive with disease. Four patients with invasive cancers died, including two died of diseases; one died of other cause and one died of unknown cause.
Conclusions: In summary, male MPD, similar to female MPD, is associated with underlyine breast cancer. Patients of male MPD often present at advanced stage and early diagnosis is important in survival.
Wednesday, March 6, 2013 1:00 PM
Poster Session VI # 29, Wednesday Afternoon