Paget's disease of the nipple treated successfully with cryosurgery: a series of cases report

Abstract

Introduction: Paget's disease of the nipple is a rare form of breast malignancy. Underlying breast cancer, either in situ or invasive accompanies lesions of the nipple in most of the cases. The connection between both entities and their exact origin remains unclear. Nevertheless, underlying ductal breast cancer is often confined to the central, subareolar part of the breast. Radical mastectomy, although successful, seems to be too mutilating treatment in the era of breast sparing surgery. Studies describing breast conserving surgery performed without adjuvant treatment are rare and the patients not numerous. Due to low incidence of the disease, there are no randomised trials conducted which could show the optimal method of treatment.

Materials and methods: We performed cryosurgery of the affected nipple-areola complex (NAC) in treatment of six patients with Paget's disease of the nipple who presented general contraindications or lack of consent for surgery.

Results: With a follow up ranging from 60 to 121 months (average 94) we obtained very good results in terms of disease specific survival: there were two cases of recurrent disease, confined to the scar and treated successfully with cryosurgery again; four patients are alive without disease. Death was not related to cancer in the remained two cases.

Conclusions: Cryotherapy is successful form of treatment of localised Paget's disease of the nipple--especially in face of contraindications for surgery or lack of patient's agreement for operational treatment.