Paget's disease of the breast (POB) occurs in approximately 1~3% of all primary breast carcinomas. This study aimed to determine the optimal surgical treatments for POB in this study.

The medical records of 16 patients with POB who had been treated between January 1986 and December 1998 were clinically reviewed retrospectively.

13 patients had nipple changes consistent with clinical Paget' disease (CPO) including 8 who had an associated breast mass, and 5 who had no associated mass. Of the 13 patients with CPO, 12 were treated with a modified radical mastectomy while 1 was treated with a radical mastectomy. Breast cancer (BC) was found in all of 13 patients (100%) with CPO. The BC was centrally located in 46% of patients including 38% in CPO associated with the mass and 60% in CPO not associated with the mass. Out of 8 CPO patients associated with the mass, 7 (88%) had invasive cancer, 1 (12%) had a ductal carcinoma in situ (OCIS), and 2 (25%) had pathologic axillary nodes (PAN). The 5 year survival rate was 87.5%. Of the 5 CPO patients not associated with the mass, 4 (80%) had an invasive cancer, 1 (20%) had a OCIS and none had PAN. Their 5 year survival rate is 100%.

All the patients with CPO had an associated BC. BC is more frequently centrally located in the CPO not associated with the mass (60%) than those associated with the mass (38%). Contrarily, the BC in CPO that was not associated with the mass was located more peripherally (40%). Therefore, the treatment of patients with CPO must be individualized in order to avoid under or overtreatment.