Paget’s Disease of the Breast, underlying breast cancer mimicking as Benign Dermatological Conditions: Clinical Challenges and Diagnostic Considerations

Mammary Paget's disease (MPD), also known as Paget's disease of the breast, is an uncommon dermatological cancer of the nipple-areolar complex that can cause anything from redness and itching to more serious symptoms like breast lumps, destruction of the nipple-areolar complex, or nipple discharge. It is typically linked to either invasive ductal carcinoma or an underlying ductal carcinoma in situ. MPD can cause delayed diagnosis and improper therapy because it frequently presents as various benign and malignant dermatological disorders, such as eczema, atopic dermatitis, psoriasis, and squamous and basal cell carcinomas. Since only one-third of patients have a palpable lump when they first arrive, MPD should be suspected in patients who are older and have unilateral, persistent lesions. In order to distinguish MPD from other skin illnesses, our review paper highlights the major findings of clinical features and diagnostic workup. It also includes case studies of MPD mimicking other skin conditions. According to a study of the literature, research advises against using mammograms and ultrasounds alone to diagnose MPD, especially when there isn't a palpable lump. This demonstrates that the MRI is a better and more precise imaging method. However, because MRI results can occasionally be negative when there is a biopsy-proven MPD present, any suspicious lesion needs to be biopsied in order to undergo histological and immunohistochemical analysis. This highlights the need for clinicians to explore any suspicious lesion of the nipple or breast using the complete triple evaluation technique to exclude an underlying cancer. It is vital to establish therapeutic criteria to treat any nipple lesion to limit the risk of misdiagnosing any underlying cancer, which can be potentially lethal if left alone.