Paget's disease of the breast medical therapy

Chemotherapy and radiotherapy are indicated for Paget’s disease of the breast as adjuvant therapy or palliative treatment in patients with underlying ductal carcinoma or invasive breast cancer. Surgery is the mainstay of treatment for Paget’s disease of the breast.

The mainstay of treatment for Paget’s disease of the breast is surgery. Non-operative management is reserved for a very small proportion of patients. ^[1]

• The mainstay of therapies for Paget’s disease of the breast are divided into 2 groups: hormonal therapy and targeted therapy.
• The primary goal of medical therapy is to reduce the risk of ipsilateral or contralateral breast invasion and also decreases the risk of recurrence.^[2][3][4]

Corticosteroids

• Temporary resolution of eczematous changes of nipple–areolar complex is possible with the application of topical corticosteroids but this may cause delay in diagnosis.
• Paget’s disease must be considered in all cases of eczematous breast lesions that persist for more than three weeks despite topical treatment.

Hormonal Therapy

• Selective estrogen receptor modulators, such as:
• Tamoxifen
• Raloxifene

Targeted Therapy

• HER2/neu/c-erb-B2-directed therapy
• Trastuzumab

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