Insitu paget disease of breast: A case report

Introduction: Mammary Paget’s disease is generally accompanied by in situ ductal carcinoma, consequently, prompt diagnosis and treatment can halt further invasion and yield better prognosis. Case Presentation: The patient was a 39-year old woman, who presented with superficial ulcers and nipple discharge of left breast, She had no palpable mass underneath. The patient was G2 P2 and under oral contraception for 5 years after the first pregnancy. Previously she was treated for eczema and after a week she had no remission. Biopsy of left nipple was performed and pathology reported Paget’s disease and in situ ductal carcinoma. The patient underwent breast conserving surgery and axillary sentinel lymph node biopsy. In the first week after operation, she developed a massive surgical site hematoma. With drainage of hematoma, the swelling of breast was reduced. Subsequently, due to considerable extension of tumor she underwent mastectomy and axillary lymph node dissection. Pathology report of the second operation was second grade invasive ductal carcinoma without any lymph node involvement. Conclusion: Consistent with clinical features of mammary Paget’s disease, the proper evaluation of probable malignant lesions are necessary even in younger patients.