Sonia Ortiz-Pagan, S. Narayan, S. Crawford, R. Quinlan, A. Larkin, A. Kahn, A. Layeequr R. Rahman
University of Massachusetts Memorial Medical Center; Worcester, MA
PURPOSE OF STUDY:
Introduction: Paget’s disease of the breast is almost always associated with an underlying breast cancer. Whether the presence of Paget’s disease in patients with breast cancer represents a worse prognosis is unknown. The purpose of this study is to compare the outcome in age and stage matched breast cancer patients with and without Paget’s disease.
METHODS USED:
Data were obtained from a prospectively maintained database that included patients treated for breast cancer. These patients were matched for stage and age at diagnosis within 10 years. Every patient with Paget’s disease was matched to a breast cancer patient without Paget’s (1:1). Disease status at last follow up was analyzed using Kaplan-Meier statistics.
SUMMARY OF RESULTS:
Thirty two patients had Paget’s disease of the breast (21 associated with invasive and 11 with in situ cancer). Thirty-two breast cancer patients were identified matched with age and stage of disease. Median (interquartile) follow up was 46 (23-76) months. Twenty nine (91%) with Paget’s versus 6 (19%) without Paget’s disease underwent mastectomy (p< 0.0001; 14 (44%) with Paget’s disease had radiation compared to 27 (84%) (p=0.0015). Other treatment and biological markers were not significantly different. Patients with Paget’s disease had an overall 5 year survival of 87% versus 97% in patients without Paget’s (Kaplan-Meier p= 0.08). Ten year disease free survival in Paget’s versus non Paget’s disease group was 70% versus 85% (Kaplan-Meier p= 0.44).
CONCLUSIONS:
Although small sample size precludes statistical significance, the data show that patients with Paget’s disease of the breast may have poorer overall and disease free survival than stage-matched breast cancer patients.