An Unusual Presentation of Involvement of Overlying Skin of the Breast with Paget’s Disease

This chapter is unique in regard to its unusual presentation as there was involvement of almost entire breast skin along with its nipple-areola complex. The clinical appearance of the Paget's disease is usually a thickened, sometimes pigmented, eczematoid, erythematous weeping or crusted lesion with irregular borders. It is rare type of cancer with tumors inside the same breast which may be either ductal carcinoma in-situ or invasive breast cancer. We report a 78 year old women (with no comorbidity & prior history of laparoscopic cholecystectomy for gall stones) presented with gradually progressive eczematous lesion over nipple, areola and left breast skin for last 15 years. Histology may reveal hyperkeratosis, parakeratosis or acanthosis of the epidermis and infiltration with classical Paget cells that are large, ovoid, have pale vacuolated cytoplasm and hyperchromatic nuclei.