Breast carcinoma (multicentric multifocal in mammary Paget's disease)

Discussion:

Typical signs of Paget's disease are erythema, eczema, scaling, erosion, ulceration and retraction of nipple areolar complex that may misled the diagnosis of benign dermatological lesion.

In this case, there is high index of suspicion toward underlying breast malignancy as patient also has bloody nipple discharge.

The common histological type of breast carcinoma in Paget's disease is DCIS which is centrally located tumor. However for peripherally located tumor (as in this case), commonly have multifocal multicentric lesions because tumors spread along the ducts and show histological type of Invasive Carcinoma. The other histological type is microinvasive carcinoma.

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