Memenin Paget Hastalığı Deneyimimiz

Yıl 2014, Cilt: 5 Sayı: 2, 45 - 50, 30.08.2014

Oktay Karaköse Hüseyin Pülat Mehmet Benzin Gökhan Avşar Girayhan Çelik Mehmet Sabuncuoğlu Hasan Eroğlu Mahmut Bülbül

Öz

Amaç: Memenin Paget hastalığı meme başında karekteristik egzematöz değişikliklerle seyreden, tüm meme kanserli hastaların % 1-4.3 'ünü oluşturan nadir bir hastalıktır. Bu çalışmada memenin Paget hastalığı tanısıyla cerrahi tedavi uyguladığımız hastalarımızın klinikopatolojik bulgularını ve tedavi yaklaşımımızı sunmayı amaçladık.
Yöntem ve Gereçler: Kliniğimizde 2006-2013 yılları arasında memenin Paget hastalığı nedeniyle tedavi gören 13 hastanın tıbbi kayıtları geriye dönük olarak incelendi.
Bulgular: Kliniğimize başvuran meme kanserli hastaların % 3,15'ini memenin Paget hastalığı oluşturduğu saptanmıştır. Hastaların ortanca yaşı 54(29-87) idi. Meme başında lezyon olan hastaların topikal tedavi kullanımı nedeniyle tanı konulmasında gecikme olduğu görüldü. Meme başında lezyon dışında memede kitle diğer başvuru şikayeti idi. Hastaların tamamına modifiye radikal mastektomi uygulandı. Hastalar ortalama 27 (3-52) ay takip edildi. Radyolojik incelemeyle yanlış negatif sonuçlar olabileceği görüldü. Özellikle DKIS olan hastalarda ultrasonografinin yararı olmadığı görüldü. Takip süresince bir hastada multipl kemik meteastazları gelişti. Diğer hastalarda nüks ya da metastaz saptanmadı.
Sonuç: MemeninPaget hastalığı, meme başında egzematöz değişikliklerle karakterize, tamamına yakını altta yatan invaziv veya non-invaziv meme kanseri ile ilişkili bir hastalıktır. Nadir olarak altta malign bir patoloji olmadan da hastalık gelişmektedir. Memenin Paget hastalığı öncelikle bir klinik tanıdır. Kullanılan topikal tedaviler veya tanının sadece radyolojik bulgulara dayandırılması tanıda gecikmeye neden olabilir. Oluşabilecek nüksler göz önüne alındığında, standart tedavisi mastektomidir. Ancak uygun hastalara meme koruyucu cerrahi de yapılabilir.

Anahtar Kelimeler

Meme kanseri, meme başı, Paget hastalığı, meme

Experience with Paget's Disease of the Breast

Öz

Objective: Paget's disease of the breast is a rare disease, is just 1-4.3% of all breast cancer patient and causing characteristic eczematous changes at the nipple. In this study, we aimed to present clinicopathological findings and treatment approach of the patients were treated surgically in the diagnosis of Paget's disease of thebreast.
MaterialsandMethods: Thirteen patients medical records, which were treated for Paget's disease of the breast in our clinic between 2006 - 2013, were analyzed retrospectively.
Results: 3.15% of patients admitted to our clinic with breast cancer has been diagnosed as Paget's disease of the breast. The median age of patients was 54 (29-87) years. It was found that the use of topical treatment of patients with lesion in the nipple causes delay in diagnosing. The other complaint of the patients was the breast mass. All patients were performed modified radical mastectomy procedure. Patients were followed up for an average of 27 (3-52) months. Radiologic examinations has shown there may be false-negative results. Ultrasonography showed no benefit, especially in patients with DCIS. There has been a patient with multiple bone metastases during follow-up. There was no recurrence or metastasis on the other patients.
Conclusion: Paget's disease is primarily a clinical diagnosis. Topical treatments and diagnosing only based on radiological findings may cause delay in diagnosis. In consideration of occurrence of relapses, mastectomy is the Standard treatment. However, breast-conserving surgery can also be done in selected patients.

Anahtar Kelimeler

Breast cancer, nipple, Paget’s disease, mammary

Kaynakça

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