Obgyn: Mammary Paget's Disease: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Mammary Paget’s Disease🎧 A clear, high-yield breakdown of this rare nipple-involved breast cancer – perfect for exam prep and clinical awareness.🧠 Key Learning Points📌 Definition• Rare form of breast cancer involving the nipple and areola• Characterised by malignant Paget cells in the skin• Strongly associated with underlying DCIS or invasive carcinoma📌 Causes & Risk Factors• Unknown exact cause, but often due to migration of cancer cells from DCIS• Advanced age (>50)• Female sex (but can occur in men)• Family history of breast cancer• BRCA1/BRCA2 mutations• Previous breast cancer or surgery💡 Mnemonic: “FAM-BP” = Female, Age, Mutation, Breast cancer hx, Prior surgery📌 Pathophysiology• Paget cells infiltrate the epidermis of nipple/areola• Often originate from deeper ductal malignancy• Replace normal epithelium causing surface changes📌 Symptoms• Eczema-like changes to nipple: scaling, redness, crusting• Itching, burning, ulceration• Nipple inversion or discharge (possibly bloody)• Possible palpable lump → suggests invasive cancer🎯 Mnemonic: “SCRUB-IN” = Scaling, Crust, Redness, Ulcer, Bloody discharge, Inversion, Nodule📌 Differential Diagnosis• Eczema• Psoriasis• Nipple adenoma• Melanoma🎯 Always rule out Paget’s first if “eczema” on nipple persists📌 Diagnosis• Skin biopsy (to detect Paget cells)• Mammography and/or MRI (to detect DCIS or invasive cancer)• Core biopsy if a lump is palpable📌 Management• Surgery is mainstay (mastectomy or breast-conserving surgery)• Radiotherapy often added post-op• Hormonal therapy (if ER+ cancer)• Chemotherapy if invasive or high risk📌 NICE supports conservative surgery in selected cases📌 Complications• Progression to invasive cancer• Local recurrence or metastasis• Diagnostic delays → worse outcomes• Psychological impact post-treatment📌 Prognosis• Best with early DCIS-only cases• Worse if associated with invasive cancer• Five-year survival: ~80% for DCIS, ~30% in men🧠 Diagnostic delay is common and harms outcomes📎 More MSRA Resources for Mammary Paget’s Disease📝 Revision Notes: https://www.passthemsra.com/topic/mammary-pagets-disease-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/mammary-pagets-disease-flashcards/💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/mammary-pagets-disease-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/mammary-pagets-disease-rapid-quiz/🎓 Full Course: https://www.passthemsra.com/courses/obstetrics-and-gynaecology-for-the-msra/🔖 Hashtags#MSRA #MSRARevision #MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQ&ANotes #MSRAAccordions #MultiSpecialityRecruitmentAssessment #MSRAOnlineRevision #MSRARevisionWebsite #MammaryPagetsDisease