PAGETS-DISEASE OF THE NIPPLE AND BREAST-CANCER - PROBLEMS WITH DIAGNOSIS

32 patients with clinical and biopsy proven Paget's disease of the nip ple were treated over a 25-year period at three Bristol hospitals. Fou r additional cases which had Paget's change found histologically are i ncluded. 16 patients had a palpable mass in addition to nipple changes . Definitive treatment included; a modified radical mastectomy (18), s imple mastectomy (11), wedge excision (4) wide local excision and radi otherapy (2) and tamoxifen alone (1). An associated invasive palpable tumour proved the most significant prognostic factor being present in 7 of 8 patients demonstrating recurrence within 5 years. Mammography r evealed a high false negative rate (8 of 17) but was the single positi ve investigation in one patient. Scrape smear cytology of the nipple s kin eruption was positive in the 6 cases examined and may be the prefe rred choice of diagnostic technique.