Pagets Disease of Left Nipple Areola Complex with Underlying Invasive Ductal Carcinoma a Diagnostic Dilemma and its Management - A Case Report from Barpeta District of Assam

Pagets disease of the breast is a rare condition presenting in 0.5% to 5% of all breast cancer cases. It is often associated with an underlying in situ or invasive carcinoma. In this case report we review a 36 year lady presenting with pagets disease of the left nipple areola complex with left axillary matted lymph node in central quadrant. The dilema pertaining to this case is the histopathological report showing features of pagets disease without carcinoma after two repeat biopsies. Even on image guided biopsy histopathology was still that of pagets disease. FNAC from left axillary lymph node showed reactive changes and metastatic workup showed localised disease. The initial workup and management including final outcome is discussed in this case report.