Having invasive ductal carcinoma and Paget disease is associated with an increased risk of axillary lymph node metastasis, but not with inferior survival, a new study published online ahead of print in the journal Cancer has shown.1

For the study, researchers from Harvard School of Public Health and Dana-Farber Cancer Institute in Boston, MA, sought to assess the effect of Paget disease on axillary lymph node metastases and survival in patients with concomitant invasive ductal carcinoma.

The researchers analyzed data from 1,102 patients with both diseases and 302,242 controls with invasive ductal carcinoma alone included in the Surveillance, Epidemiology, and End Results (SEER) database. All women were diagnosed between 2000 and 2011.

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Results showed that women with both tumors were more likely to have centrally located, high grade, >2 cm in greatest dimension, and estrogen/progesterone receptor-negative tumors (all P<0.001).

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The study demonstrated that patients with Paget disease and invasive ductal carcinoma had a higher risk for axillary lymph node metastasis (OR = 1.83; P<0.001).

Researchers found that the unadjusted 10-year breast cancer-specific and overall survival rates were lower for the patients with both tumors compared with those with invasive ductal carcinoma alone, but after adjusting for confounding factors, there were no significant differences in mortality (P=0.24).


  1. Wong SM, Freedman RA, Sagara Y, et al. The effect of Paget disease on axillary lymph node metastases and survival in invasive ductal carcinoma [published online ahead of print September 16, 2015]. doi: 10.1002/cncr.29687.