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: Pagetís disease of the breast is almost always associated with an underlying breast cancer. Whether the presence of Pagetís 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 Pagetís disease.
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 Pagetís disease was matched to a breast cancer patient without Pagetís (1:1). Disease status at last follow up was analyzed using Kaplan-Meier statistics.
SUMMARY OF RESULTS:
Thirty two patients had Pagetís 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 Pagetís versus 6 (19%) without Pagetís disease underwent mastectomy (p< 0.0001; 14 (44%) with Pagetís disease had radiation compared to 27 (84%) (p=0.0015). Other treatment and biological markers were not significantly different. Patients with Pagetís disease had an overall 5 year survival of 87% versus 97% in patients without Pagetís (Kaplan-Meier p= 0.08). Ten year disease free survival in Pagetís versus non Pagetís disease group was 70% versus 85% (Kaplan-Meier p= 0.44).
Although small sample size precludes statistical significance, the data show that patients with Pagetís disease of the breast may have poorer overall and disease free survival than stage-matched breast cancer patients.