Meme Kanserinde Paget Hastalığı
Özet
Meme kanserinde Paget hastalığı, meme başı ve areola kompleksini tutan nadir bir kanser alt tipidir ve tüm meme kanseri vakalarının yaklaşık %1’ini oluşturur. Genellikle ileri yaş kadınlarda görülür ve sıklıkla altta yatan duktal karsinoma in situ (DCIS) veya invaziv duktal karsinom ile birliktedir. Klinik olarak meme başında kızarıklık, pullanma, ülserasyon ve kaşıntı gibi dermatolojik şikayetlerle ortaya çıkabilir. Tanıda mamografi, ultrason ve MRG gibi görüntüleme yöntemleri kullanılır; ancak kesin tanı histopatoloji ve immünohistokimyasal boyamalarla konur (özellikle CK7 ve HER2 pozitifliği). Tedavi, hastalığın yaygınlığına göre belirlenir. Mastektomi uzun yıllar standart yaklaşım olmuştur; ancak uygun hastalarda meme koruyucu cerrahi ve radyoterapi güvenli seçeneklerdir. Adjuvan tedavi ihtiyacı, eşlik eden invaziv kanser varlığına göre belirlenir. Multidisipliner değerlendirme, optimal onkolojik ve kozmetik sonuçlar için önemlidir.
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