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Recommendation
Paget's disease of the nipple – BCS or mastectomy
In patients with Paget’s disease of the nipple with or without underlying breast cancer, offer breast-conserving surgery with removal of the nipple/areolar complex followed by whole breast radiation therapy, as an alternative to mastectomy.
Breast-conserving surgery with removal of the nipple–areolar complex followed by radiotherapy should be offered as an alternative to mastectomy in patients with Paget’s disease without underlying invasive breast cancer (Weak recommendation based on low or very low level evidence)
The desirable effects of an intervention probably outweigh the undesirable effects (the intervention probably is to be put into practice), or the undesirable effects of an intervention probably outweigh the desirable effects (the intervention probably is not to be put into practice)
How this guidance was developed
This recommendation was adapted from the KCE 2013 guideline (Belgium). The source recommendation was based on a systematic review of the evidence conducted to January 2010 and was graded ‘weak' (using GRADE methods) by the source guideline authors. The recommendation was adapted by expanding the patient population to include patients with Paget's disease with underlying invasive breast cancer.
Paget's disease of the nipple – BCS or mastectomy
Recommendation
In patients with Paget’s disease of the nipple with or without underlying breast cancer, offer breast-conserving surgery with removal of the nipple/areolar complex followed by whole breast radiation therapy, as an alternative to mastectomy.
Principles in action
Safe and quality care
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Communication
This recommendation was adapted from the KCE 2013 guideline (Belgium). The source recommendation was based on a systematic review of the evidence conducted to January 2010 and was graded ‘weak' (using GRADE methods) by the source guideline authors. The recommendation was adapted by expanding the patient population to include patients with Paget's disease with underlying invasive breast cancer.