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Pathology

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Histologic examination of the nipple reveals multiple Paget cells:

  • clear
  • sited among the basal epidermal cells
  • typical ballooned appearance
  • pale cytoplasm
  • prominent nuclei
  • nucleus surrounded by halo - accumulation of intracellular mucopolysaccharide

At the skin, the epidermis is invaded. The underlying dermis contains an inflammatory infiltrate.

In the vast majority of cases, careful study of the breast reveals an associated DCIS or invasive carcinoma.

A popular theory is that Paget's disease results from invasion of the nipple by malignant cells spreading down the ducts from the associated breast tumour.

Other theories propose that the Paget cells arise in the nipple from local epidermal cells, and that the concurrence of DCIS and nipple malignant cells are due to common carcinogenic influences.


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