Paget's disease of the breast medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Preeti Singh, M.B.B.S.[2]
Overview
Chemotherapy and radiotherapy are indicated for Paget's disease of the breast as adjuvant therapy or palliative treatment in patients with underlying ductal carcinoma or invasive breast cancer. Surgery is the mainstay of treatment for Paget's disease of the breast.
Medical Therapy
The mainstay of treatment for Paget's disease of the breast is surgery. Non-operative management is reserved for a very small proportion of patients. [1]
Non-operative management
- The mainstay of therapies for Paget's disease of the breast are divided into 2 groups: hormonal therapy and targeted therapy.
- The primary goal of medical therapy is to reduce the risk of ipsilateral or contralateral breast invasion and also decreases the risk of recurrence.[2][3][4]
Corticosteroids
- Temporary resolution of eczematous changes of nipple-areolar complex is possible with the application of topical corticosteroids but this may cause delay in diagnosis.
- Paget’s disease must be considered in all cases of eczematous breast lesions that persist for more than three weeks despite topical treatment.
Hormonal Therapy
- Selective estrogen receptor modulators, such as:
- Tamoxifen
- Raloxifene
Targeted Therapy
- HER2/neu/c-erb-B2-directed therapy
- Trastuzumab
References
- ↑ Michou L, Brown JP (2011). "Emerging strategies and therapies for treatment of Paget's disease of bone". Drug Des Devel Ther. 5: 225–39. doi:10.2147/DDDT.S11306. PMC 3096538. PMID 21607019.
- ↑ Kothari AS, Beechey-Newman N, Hamed H, Fentiman IS, D'Arrigo C, Hanby AM, Ryder K (July 2002). "Paget disease of the nipple: a multifocal manifestation of higher-risk disease". Cancer. 95 (1): 1–7. doi:10.1002/cncr.10638. PMID 12115309.
- ↑ Song Q, Jin Y, Huang T, Zhang JH (2015). "Diagnosis and treatment of Paget's disease of the breast: an analysis of 72 cases". Int J Clin Exp Med. 8 (10): 19616–20. PMC 4694522. PMID 26770622.
- ↑ Virnig BA, Tuttle TM, Shamliyan T, Kane RL (2010). "Ductal carcinoma in situ of the breast: a systematic review of incidence, treatment, and outcomes". J. Natl. Cancer Inst. 102 (3): 170–8. doi:10.1093/jnci/djp482. PMID 20071685.