Paget's Disease of the Breast Mimicking a Chronic Wound

Paget's disease of the breast is a rare malignancy of the nipple-areola complex and accounts for 1%-4% of all breast cancers. The disease is frequently associated with an underlying in-situ or invasive carcinoma in the breast tissue that extends to the nipple and areola. Paget's disease is characterized clinically by eczema-like inflammatory skin changes and histologically by malignant cell infiltration in the dermis (Paget's cells). Although Paget's presents less commonly than a palpable mass or mammography abnormality, it is an important consideration in the differential diagnosis of a persisting nipple-areola abnormality. Diagnosis may be delayed by several months or even years because of Paget's seemingly benign appearance. The following case demonstrates this particular situation. Biopsy of a chronic wound that shows no evidence of healing over time is of paramount importance, especially in the case of a chronic breast lesion.