RISK FACTORS: Early menarche, Late menopause, Nulliparity, First birth after age 30, Family history of breast cancer, History of radiation exposure, History of alcohol use, Proliferative benign breast disease
APPROPRIATE HEALTH CARE Treatment of the underlying breast cancer with surgery. Additional adjuvant chemotherapy and/or radiation therapy dependent on cancer histology, size and stage.
GENERAL MEASURES
β’ Radiotherapy
β’ Chemotherapy
β’ Hormonal manipulation
SURGICAL MEASURES To be determined by surgeon
DRUG(S) OF CHOICE
. Chemotherapy per oncology study protocols
. Doxorubicin (Adriamycin) based regimen
. CMF - cyclophosphamide, methotrexate, 5-fluorouracil
. Tamoxifen
. Paclitaxel (Taxol)
PATIENT MONITORING
. Routine screening for women over age 40
. Annual mammogram
. Monthly self-exams
. Annual physician exams
PREVENTION/AVOIDANCE None known
POSSIBLE COMPLICATIONS Metastases
EXPECTED COURSE/PROGNOSIS
. Dependent on stage of underlying breast carcinoma
Ten year survival for Paget disease
Stage 10yr*
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1 < 2 cm tumor; - nodes 70-95%
2 > 2 cm tumor or + nodes 40-45%
3 > 5 cm tumor; + nodes or
fixed nodes 10-15%
4 Metastatic disease <5%
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*10 year disease-free survival