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乳房Paget病的相关研究进展
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Abstract:
近年来，乳腺癌的发病率居高不下，其中乳房Paget病(Mammary Paget disease, MPD)为一种相对罕见的乳腺癌。MPD是一种以乳头鳞状上皮内出现恶性腺上皮细胞(佩吉特细胞)为特征的乳腺癌，可能累及乳晕和邻近的皮肤，通常和乳房深部的癌相关。MPD根据有无乳房深部恶性病变，可分为3种类型：(1) 乳头乳晕区湿疹样改变合并乳腺浸润性癌成分(约56%)；(2) 乳头乳晕区的湿疹样改变合并导管内癌(约32%)；(3) 不伴有任何乳腺深部病灶的单纯乳头乳晕区湿疹样改变(约12%)。因目前MPD发病机制尚不完全清楚、最佳手术治疗的共识仍然存在争议以及综合治疗指南很少，所以MPD也逐渐引起了诸多学者的关注。因此，在本文中，我们将讨论MPD的发病机制以及治疗方案，为临床更好地诊治MPD提供依据。
In recent years, the incidence of breast cancer has remained high, among which Mammary Paget disease (MPD) is a relatively rare breast cancer. MPD is a type of breast cancer characterized by the presence of malignant glandular epithelial cells (Paget cells) within the papillary squamous epithelium, which may involve the areola and adjacent skin, and is usually associated with deep breast cancer. According to the presence or absence of deep breast malignant lesions, MPD could be divided into three types: (1) eczema-like changes in the nipple areola combined with breast invasive carcinoma components (about 56%); (2) eczema-like changes in the nipple areola combined with intraductal carcinoma (about 32%); (3) Simple eczema-like changes in the nipple areola region without any deep breast lesions (about 12%). At present, the pathogenesis of MPD is not fully understood, the consensus of the best surgical treatment is still controversial, and the comprehensive treatment guidelines are few, so MPD has gradually attracted the attention of many scholars. Therefore, in this paper, we will discuss the pathogenesis and treatment of MPD, so as to provide a basis for better clinical diagnosis and treatment of MPD.
| [1] | Chen, C., Sun, L. and Anderson, B.O. (2006) Paget Disease of the Breast: Changing Patterns of Incidence, Clinical Presentation, and Treatment in the U.S. Cancer, 107, 1448-1458. https://doi.org/10.1002/cncr.22137 |
| [2] | Sanders, M.A., Brock, J.E., Harrison, B.T., Wieczorek, T.J., Hong, X., Guidi, A.J., et al. (2018) Nipple-Invasive Primary Carcinomas: Clinical, Imaging, and Pathologic Features of Breast Carcinomas Originating in the Nipple. Archives of Pathology & Laboratory Medicine, 142, 598-605. https://doi.org/10.5858/arpa.2017-0226-oa |
| [3] | Aguayo-Carreras, P., Bonilla-García, L., Pérez-López, I., Cuenca-Barrales, C. and Tercedor-Sánchez, J. (2018) Paget’s Disease of the Breast: A Dangerous Imitator of Eczema. Sultan Qaboos University Medical Journal, 17, 487-488. https://doi.org/10.18295/squmj.2017.17.04.021 |
| [4] | Zakaria, S., Pantvaidya, G., Ghosh, K. and Degnim, A.C. (2006) Paget’s Disease of the Breast: Accuracy of Preoperative Assessment. Breast Cancer Research and Treatment, 102, 137-142. https://doi.org/10.1007/s10549-006-9329-2 |
| [5] | Chaudary, M.A., Millis, R.R., Lane, E.B. and Miller, N.A. (1986) Paget’s Disease of the Nipple: A Ten Year Review Including Clinical, Pathological, and Immunohistochemical Findings. Breast Cancer Research and Treatment, 8, 139-146. https://doi.org/10.1007/bf01807702 |
| [6] | Choridah, L., Sari, W.K., Dwianingsih, E.K., Widodo, I., Suwardjo, and Anwar, S.L. (2020) Advanced Lesions of Synchronous Bilateral Mammary Paget’s Disease: A Case Report. Journal of Medical Case Reports, 14, Article No. 119. https://doi.org/10.1186/s13256-020-02442-5 |
| [7] | Wong, S.M., Freedman, R.A., Sagara, Y., Stamell, E.F., Desantis, S.D., Barry, W.T., et al. (2015) The Effect of Paget Disease on Axillary Lymph Node Metastases and Survival in Invasive Ductal Carcinoma. Cancer, 121, 4333-4340. https://doi.org/10.1002/cncr.29687 |
| [8] | Lopes Filho, L.L., Lopes, I.M.R.S., Lopes, L.R.S., Enokihara, M.M.S.S., Michalany, A.O. and Matsunaga, N. (2015) Mammary and Extramammary Paget’s Disease. Anais Brasileiros de Dermatologia, 90, 225-231. https://doi.org/10.1590/abd1806-4841.20153189 |
| [9] | Di Tommaso, L., Franchi, G., Destro, A., Broglia, F., Minuti, F., Rahal, D., et al. (2008) Toker Cells of the Breast. Morphological and Immunohistochemical Characterization of 40 Cases. Human Pathology, 39, 1295-1300. https://doi.org/10.1016/j.humpath.2008.01.018 |
| [10] | Association of Breast Surgery at BASO 2009 (2009) Surgical Guidelines for the Management of Breast Cancer. European Journal of Surgical Oncology, 35, S1-S22. https://doi.org/10.1016/j.ejso.2009.01.008 |
| [11] | Sripathi, S., Ayachit, A., Kadavigere, R., Kumar, S., Eleti, A. and Sraj, A. (2015) Spectrum of Imaging Findings in Paget’s Disease of the Breast—A Pictorial Review. Insights into Imaging, 6, 419-429. https://doi.org/10.1007/s13244-015-0415-z |
| [12] | Bijker, N., Rutgers, E.J.T., Duchateau, L., Peterse, J.L., Julien, J. and Cataliotti, L. (2001) Breast-Conserving Therapy for Paget Disease of the Nipple. Cancer, 91, 472-477. https://doi.org/10.1002/1097-0142(20010201)91:3<472::aid-cncr1024>3.0.co;2-q |
| [13] | Kawase, K., DiMaio, D.J., Tucker, S.L., Buchholz, T.A., Ross, M.I., Feig, B.W., et al. (2005) Paget’s Disease of the Breast: There Is a Role for Breast-Conserving Therapy. Annals of Surgical Oncology, 12, 391-397. https://doi.org/10.1245/aso.2005.05.026 |
| [14] | Helme, S., Harvey, K. and Agrawal, A. (2015) Breast-Conserving Surgery in Patients with Paget’s Disease. British Journal of Surgery, 102, 1167-1174. https://doi.org/10.1002/bjs.9863 |
| [15] | Li, Y., Huang, X. and Zhou, X. (2014) Local Breast Cancer Recurrence after Mastectomy and Breast-Conserving Surgery for Paget’s Disease: A Meta-Analysis. Breast Care, 9, 431-434. https://doi.org/10.1159/000368431 |
| [16] | Signorini, M., Grisotti, A., Ponzielli, G., Pajardi, G. and Gilardino, P. (1994) Self-Expanding Prostheses Complicating Augmentation Mammoplasties. Aesthetic Plastic Surgery, 18, 195-199. https://doi.org/10.1007/bf00454482 |
| [17] | Chen, Y., Chen, Q., Dong, J., Liu, D., Huang, L., Xie, F., et al. (2021) Modified Grisotti Flap Technique in Centrally Located Breast Cancer: Case Report. Gland Surgery, 10, 2867-2873. https://doi.org/10.21037/gs-21-176 |
| [18] | Kothari, A.S., Beechey-Newman, N., Hamed, H., Fentiman, I.S., D’Arrigo, C., Hanby, A.M., et al. (2002) Paget Disease of the Nipple. Cancer, 95, 1-7. https://doi.org/10.1002/cncr.10638 |
| [19] | Dixon, J.M., Rodger, A. and Stebbing, J. (2005) Breast Cancer (Non-Metastatic). Clinical Evidence, No. 13, 2226-2257. |
| [20] | Laronga, C., Hasson, D., Hoover, S., Cox, J., Cantor, A., Cox, C., et al. (2006) Paget’s Disease in the Era of Sentinel Lymph Node Biopsy. The American Journal of Surgery, 192, 481-483. https://doi.org/10.1016/j.amjsurg.2006.06.023 |
| [21] | Fourquet, A., Campana, F., Vielh, P., Schlienger, P., Jullien, D. and Vilcoq, J.R. (1987) Paget’s Disease of the Nipple without Detectable Breast Tumor: Conservative Management with Radiation Therapy. International Journal of Radiation Oncology？Biology？Physics, 13, 1463-1465. https://doi.org/10.1016/0360-3016(87)90311-7 |
| [22] | Marshall, J.K., Griffith, K.A., Haffty, B.G., Solin, L.J., Vicini, F.A., McCormick, B., et al. (2003) Conservative Management of Paget Disease of the Breast with Radiotherapy. Cancer, 97, 2142-2149. https://doi.org/10.1002/cncr.11337 |
| [23] | Pierce, L.J., Haffty, B.G., Solin, L.J., McCormick, B., Vicini, F.A., Wazer, D.E., et al. (1997) The Conservative Management of Paget’s Disease of the Breast with Radiotherapy. Cancer, 80, 1065-1072. https://doi.org/10.1002/(sici)1097-0142(19970915)80:6<1065::aid-cncr8>3.0.co;2-8 |
| [24] | Rozen, W.M. and Ashton, M.W. (2012) Radiotherapy and Breast Reconstruction: Oncology, Cosmesis and Complications. Gland Surgery, 1, 119-127. |
| [25] | Ng, E.T., Ang, R.Z., Tran, B.X., Ho, C.S., Zhang, Z., Tan, W., et al. (2019) Comparing Quality of Life in Breast Cancer Patients Who Underwent Mastectomy versus Breast-Conserving Surgery: A Meta-Analysis. International Journal of Environmental Research and Public Health, 16, Article 4970. https://doi.org/10.3390/ijerph16244970 |
| [26] | Wei, C.H., Scott, A.M., Price, A.N., Miller, H.C., Klassen, A.F., Jhanwar, S.M., et al. (2016) Psychosocial and Sexual Well-Being Following Nipple-Sparing Mastectomy and Reconstruction. The Breast Journal, 22, 10-17. https://doi.org/10.1111/tbj.12542 |
| [27] | Dabiri, C., Hotton, J., Wehbe, K., Gornes, H., Garbar, C., Guillemin, F., et al. (2021) Assessment of the Grisotti Oncoplastic Procedure for the Management of Central Breast Tumors. The Breast Journal, 27, 595-602. https://doi.org/10.1111/tbj.14256 |
| [28] | Bykowski, M.R., Emelife, P.I., Emelife, N.N., Chen, W., Panetta, N.J. and de la Cruz, C. (2017) Nipple-Areola Complex Reconstruction Improves Psychosocial and Sexual Well-Being in Women Treated for Breast Cancer. Journal of Plastic, Reconstructive & Aesthetic Surgery, 70, 209-214. https://doi.org/10.1016/j.bjps.2016.10.009 |
| [29] | Goh, S.C.J., Martin, N.A., Pandya, A.N. and Cutress, R.I. (2011) Patient Satisfaction Following Nipple-Areolar Complex Reconstruction and Tattooing. Journal of Plastic, Reconstructive & Aesthetic Surgery, 64, 360-363. https://doi.org/10.1016/j.bjps.2010.05.010 |
