{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T21:39:20Z","timestamp":1769031560846,"version":"3.49.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mammary Paget\u2019s Disease (MPD) is a rare subtype of breast cancer, accounting for 1%-4% of all breast cancers. Controversy remains regarding whether sentinel lymph node biopsy (SLNB) is necessary for MPD patients undergoing breast-conserving surgery (BCS) when imaging studies fail to detect deep invasive carcinoma, and this controversy lacks support from specific case evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Summary<\/jats:title>\n                    <jats:p>A patient presented with \u201crecurrent left nipple fissure for 3 years and eczematous changes for 3 months.\u201d Preoperative biopsy at another hospital confirmed MPD; imaging showed no deep mass. Postoperative pathology revealed left breast MPD associated with multifocal microinvasive carcinoma, accompanied by metastases to left axillary lymph nodes (6\/8), left subclavian lymph nodes (2\/3), and left supraclavicular lymph nodes (1\/3). The pathological stage was pT1mic pN3c cM0. No recurrence was observed 6 months after adjuvant therapy with the TCbHP regimen plus capecitabine consolidation therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although no definite mass was identified on breast magnetic resonance imaging (MRI) in this case, SLNB and subsequent pathology confirmed extensive lymph node metastasis (pN3c). Omission of SLNB could have led to understaging and compromised treatment decision-making. This single case may suggest that SLNB holds significant staging value for MPD patients with no obvious breast mass on imaging. It provides hypothesis-generating, practical evidence for addressing this controversial clinical issue, warranting further investigation in larger cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2025.1727016","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T05:35:09Z","timestamp":1768973709000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Mammary Paget\u2019s disease with multifocal microinvasive carcinoma and extensive lymph node metastasis: therapeutic challenges and insights from a case of stage pT1mic pN3c cM0"],"prefix":"10.3389","volume":"15","author":[{"given":"YiFan","family":"Luo","sequence":"first","affiliation":[{"name":"School of Medicine, Southwest Medical University of China, Department of Breast Surgery The Affiliated Hospital of Southwest Medical University","place":["Luzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ZhiYu","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People\u2019s Hospital, Affiliated Hospital of School of Medicine, University of Electronic Science and Technology of China","place":["Chengdu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Luo","sequence":"additional","affiliation":[{"name":"School of Medicine, Southwest Medical University of China, Department of Breast Surgery The Affiliated Hospital of Southwest Medical University","place":["Luzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"B1","article-title":"Paget\u2019s disease of the breast: strategy to improve oncological and aesthetic results","volume-title":"Eur Rev Med Pharmacol Sci","author":"Franceschini","year":"2021"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.19538\/j.cjps.issn1005-2208.2025.03.03","article-title":"Chinese expert consensus on diagnosis and treatment of mammary Paget\u2019s disease (2025 edition)","volume":"45","author":"Gao","year":"2025","journal-title":"Chin J Pract Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/cncr.10638","article-title":"Paget disease of the nipple: a multifocal manifestation of higher-risk disease","volume":"95","author":"Kothari","year":"2002","journal-title":"Cancer"},{"key":"B4","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.ultrasmedbio.2014.09.023","article-title":"Diagnostic evaluation of ductal carcinoma in situ of the breast: ultrasonographic, mammographic and histopathologic correlations","volume":"41","author":"Jin","year":"2015","journal-title":"Ultrasound Med Biol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.18920","article-title":"Nipple eczema: A systematic review and practical recommendations","volume":"37","author":"Reynaert","year":"2023","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.12937","article-title":"Contact allergy to finished woods in furniture and furnishings: a small allergic contact dermatitis epidemic to western red cedar in sauna interior decoration","volume":"30","author":"Huilaja","year":"2016","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.4103\/0366-6999.190674","article-title":"A case of nipple adenoma detected by sonography","volume":"129","author":"Li","year":"2016","journal-title":"Chin Med J (Engl)"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.09.3568","article-title":"Breast cancers not detected at MRI: review of false-negative lesions","volume":"194","author":"Shimauchi","year":"2010","journal-title":"Am J Roentgenology"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.2463\/mrms.2.159","article-title":"Extension of ductal carcinoma in situ: histopathological association with MR imaging and mammography","volume":"2","author":"Shiraishi","year":"2003","journal-title":"Magn Reson Med Sci"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-019-05490-8","article-title":"Paget\u2019s disease of the nipple in a Her2-positive breast cancer xenograft model","volume":"179","author":"Drews-Elger","year":"2019","journal-title":"Breast Cancer Res Treat"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.13752","article-title":"The relationship of lymphatic vessel density, lymphovascular invasion, and lymph node metastasis in breast cancer: a systematic review and meta-analysis","volume":"8","author":"Zhang","year":"2017","journal-title":"Oncotarget"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2012.09.003","article-title":"Predictors of axillary lymph node metastases in early breast cancer and their applicability in clinical practice","volume":"22","author":"Yoshihara","year":"2013","journal-title":"Breast"},{"key":"B13","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1053\/ejso.2002.1268","article-title":"A prospective validated model for predicting axillary node metastases based on 2,000 sentinel node procedures: the role of tumor location [corrected","volume":"28","author":"Bevilacqua","year":"2002","journal-title":"Eur J Surg Oncol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21388","article-title":"The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more \u201cpersonalized\u201d approach to cancer staging","volume":"67","author":"Amin","year":"2017","journal-title":"CA Cancer J Clin"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1999.17.9.2639","article-title":"Multinational study of the efficacy and safety of humanized anti-HER2 monoclonal antibody in women who have HER2-overexpressing metastatic breast cancer that has progressed after chemotherapy for metastatic disease","volume":"17","author":"Cobleigh","year":"1999","journal-title":"J Clin Oncol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"e181100","DOI":"10.1001\/jamanetworkopen.2018.1100","article-title":"Association of radiotherapy with survival in women treated for ductal carcinoma in situ with lumpectomy or mastectomy","volume":"1","author":"Giannakeas","year":"2018","journal-title":"JAMA Netw Open"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.02.7888","article-title":"Ten-year multi-institutional results of breast-conserving surgery and radiotherapy in BRCA1\/2-associated stage I\/II breast cancer","volume":"24","author":"Pierce","year":"2006","journal-title":"J Clin Oncol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1612645","article-title":"Adjuvant capecitabine for breast cancer after preoperative chemotherapy","volume":"376","author":"Masuda","year":"2017","journal-title":"N Engl J Med"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2024.0035","article-title":"Breast cancer, version 3.2024, NCCN clinical practice guidelines in oncology","volume":"22","author":"Gradishar","year":"2024","journal-title":"J Natl Compr Canc Netw"},{"key":"B20","unstructured":"CSCO guidelines for the diagnosis and treatment of breast cancer (2025 version) [EB\/OL]"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-020-08606-3","article-title":"Role of sentinel lymph node biopsy in microinvasive breast cancer","volume":"27","author":"Fan","year":"2020","journal-title":"Ann Surg Oncol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"12391","DOI":"10.1038\/s41598-022-16521-8","article-title":"Microinvasive breast cancer and the role of sentinel lymph node biopsy","volume":"12","author":"Hacking","year":"2022","journal-title":"Sci Rep"},{"key":"B23","doi-asserted-by":"publisher","first-page":"e61455","DOI":"10.1371\/journal.pone.0061455","article-title":"Patients with nipple-areola Paget\u2019s disease and underlying invasive breast carcinoma have very poor survival: a matched cohort study","volume":"8","author":"Ling","year":"2013","journal-title":"PloS One"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.29687","article-title":"The effect of Paget disease on axillary lymph node metastases and survival in invasive ductal carcinoma","volume":"121","author":"Wong","year":"2015","journal-title":"Cancer"},{"key":"B25","doi-asserted-by":"crossref","DOI":"10.1002\/(SICI)1097-0142(19970915)80:6<1065::AID-CNCR8>3.0.CO;2-8","article-title":"The conservative management of Paget\u2019s disease of the breast with radiotherapy","volume":"80","author":"Pierce","year":"1997","journal-title":"Cancer"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1727016\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T05:35:13Z","timestamp":1768973713000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1727016\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,21]]},"references-count":25,"alternative-id":["10.3389\/fonc.2025.1727016"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2025.1727016","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,21]]},"article-number":"1727016"}}