Medical device diagnostic procedures are primarily used to clarify abnormal palpatory findings. 1st-order laboratory parameters-obligatory laboratory tests. Exfoliative cytology to detect Paget’s cells (evidential). If genetic burden is suspected BRCA gene status (BRCA1, BRCA2, BRCA3/RAD51C gene). * For women with a BRCA mutation, the risk of developing breast cancer – over the course of a … Paget’s Carcinoma: Test and Diagnosis
Therapeutic target Improvement of prognosis as adjuvant drug prevention after therapy of breast carcinoma by different endocrine therapy methods (about 80% of patients have a hormone-sensitive tumor) s. Breast carcinoma/medicinal therapy. Therapy recommendations In Paget’s disease that is causally due to ductal carcinoma in situ (DCIS; precancerous lesion) or invasive breast carcinoma, therapy is based … Paget’s Carcinoma: Drug Therapy
Obligatory medical device diagnostics. Mammography (X-ray examination of the breast) – part of breast cancer screening guidelines for women between the ages of 50 and 70; currently the only method that detects precancerous lesions/early stages; examination of both mammaries mandatory Mammasonography (ultrasound examination of the breast; breast ultrasound) – as a basic diagnostic tool in … Paget’s Carcinoma: Diagnostic Tests
1st order In Paget’s disease causally underlying ductal carcinoma in situ (DCIS) or invasive breast carcinoma, surgical therapy is guided by the standards of the underlying disease (see Therapy of Breast Carcinoma), including excision (surgical removal) of the nipple-areola complex (NAC; nipple-areola complex, MAK) In isolated Paget’s disease of the nipple-areola complex (<5%), only complete … Paget’s Carcinoma: Surgical Therapy
Medical history (history of illness) represents an important component in the diagnosis of Paget’s carcinoma. Family history Are there any people in your family who have had breast cancer? Social history Current medical history/systemic history (somatic and psychological complaints). Have you noticed any changes in the nipple (brownish-red, scaly, oozing, crusted)? Are these changes unilateral … Paget’s Carcinoma: Medical History
Skin and subcutaneous (L00-L99). Dermatoses (skin diseases) with clear cells. Clear cell acanthoma of the nipple (breast). Pagetoid dyskeratosis Hyperkeratosis (excessive severe keratinization) of the nipple. Acanthosis nigricans – skin disease characterized by planar hyperpigmentation and hyperkeratosis. Nevoid hyperkeratosis Pregnancy-associated hyperkeratosis Nipple eczema (eczema of the nipple). Allergic contact dermatitis – skin change triggered by … Paget’s Carcinoma: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by Paget’s carcinoma: Infectious and parasitic diseases (A00-B99). Infections due to weakening of the immune system Neoplasms – tumor diseases (C00-D48) Increased risk for the occurrence of breast carcinoma in the contralateral (healthy) breast. Recurrence (recurrence) of breast carcinoma in the … Paget’s Carcinoma: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin and mucous membranes Abdominal wall and inguinal region (groin area). Gynecological examination Inspection Vulva (external, primary female sexual organs). Vagina (vagina) Cervix uteri (cervix) or portio (cervix; transition … Paget’s Carcinoma: Examination
For prevention of Paget’s carcinoma or breast carcinoma, attention must be paid to reducing individual risk factors. If BRCA gene status is positive (see Laboratory Diagnostics for details), risk-reducing mastectomy (RRM; removal of the mammary gland) is indicated. Behavioral risk factors Diet High-fat diet – a high-fat diet with a high proportion of red meat, … Paget’s Carcinoma: Prevention
The following symptoms and complaints may indicate Paget’s carcinoma: Leading symptoms Slowly progressive change in the nipple (breast) – brownish-red, scaly, weeping, crusted. Paget’s carcinoma usually occurs on one side. Caution. Risk of confusion with nipple eczema, which usually occurs on both sides. Other symptoms Reddened skin Thickened skin Edema (water retention) Retraction of the … Paget’s Carcinoma: Symptoms, Complaints, Signs
Pathogenesis (disease development) Paget’s carcinoma grows predominantly intraductally (in the glandular ducts); in approximately two-thirds of cases, there is ductal carcinoma in situ (DCIS) or deep ductal breast carcinoma.If this is not the case, it is an isolated Paget’s carcinoma. Etiology (causes) Disease-related causes Neoplasms – Tumor Diseases (C00-D48). Breast carcinoma If breast carcinoma (see … Paget’s Carcinoma: Causes
General measures Nicotine restriction (refraining from tobacco use). Alcohol restriction (abstaining from alcohol) Aim for normal weight!Determination of BMI (body mass index, body mass index) or body composition using electrical impedance analysis. BMI ≥ 25 → participation in a medically supervised weight loss program. Falling below the BMI lower limit (from the age of 45: … Paget’s Carcinoma: Therapy
