Paget disease of the nipple is associated with an underlying invasive or in-situ carcinoma in approximately what percentage of cases, and the malignant Paget cells spread from the underlying carcinoma via which route?
- A ~95% of cases; Paget cells migrate from underlying DCIS or invasive carcinoma through the lactiferous ducts to the nipple epidermis ✓
- B ~50% of cases; Paget cells arise de novo in the nipple epidermis independently
- C ~100% of cases; Paget cells are always derived from melanocytes undergoing malignant transformation
- D ~20% of cases; most Paget disease is an inflammatory (eczematous) condition
Correct answer: A. ~95% of cases; Paget cells migrate from underlying DCIS or invasive carcinoma through the lactiferous ducts to the nipple epidermis
Explanation
Paget disease of the nipple is associated with underlying carcinoma (DCIS or invasive) in ~95% of cases. The large pale Paget cells (HER2+, CK7+) are carcinoma cells that migrate via the lactiferous ducts from the underlying tumour to the nipple epidermis. Clinically it presents as eczematous, erythematous nipple changes, which are often mistaken for dermatitis. Biopsy confirms intraepidermal Paget cells.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.