pagetoid pattern

I googled and found these defintions for you. My pathology report said the same thing, that the tumor was growing up into the dermis (skin).

Look up: pagetoid

1. pagetoid
   Resembling or characteristic of Paget's disease. ... (05 Mar 2000) ...
   Found on http://cancerweb.ncl.ac.uk/cgi-bin/omd?pagetoid
   
   
2. Pagetoid
   `Pagetoid` is a term used in dermatology to refer to `upward spreading` of melanocytes into the epidermis. It is uncommon and a possible indication of a precancerous or cancerous condition. Cells display pagetoid growth when they invade the upper epidermis from below. Squamous cell carcinoma, melanoma in situ, Pagetoid Bowen disease and other carcinomas can all display pagetoid growth. A pagetoid growth pattern with upward growth of the melanocyt...
   Found on http://en.wikipedia.org/wiki/Pagetoid
   
   
3. pagetoid
   (paj´ә-toid) resembling or characteristic of Paget disease.
   Found on http://www.mercksource.com/pp/us/cns/cns_hl_dorlands.jspzQzpgzEzzSzppdocszSzuszSzcommonzSzdorlandszSzdorlandzSz000077415zPzhtm
   
   
4. pagetoid
   Resembling or characteristic of Paget disease.
   Found on
   

This is my first post. I had bilateral mastectomy (10/13/08) for LCIS and DCIS in left breast. Path report shows LCIS with pagetoid spread into the ducts and no clear margin near the areola (less than 1 mm), no nods.

Do you think that I have to do radiation therapy? I was hoping to be done, I also have expanders for reconstruction, so I'm confused and upset about everything.

Leaf, please tell me what did you do.

Thank you

Hi nico!  I do not have DCIS, so you have a more complicated situation than I have.  If you only had LCIS, then I doubt they would do anything more after mastectomy.  However, you have DCIS in addition.  I do not know about DCIS. It was my impression that if you got clear margins in the mastectomy, and do not have anything else (no invasive) that they normally do not do chemo or rads.  I hope someone will correct me if I am wrong.

I think I read somewhere that pagetoid meant something like 'soldiers standing in a row'or something like that...

Pagetoid spread into ducts is common
May completely fill ducts
May involve sclerosing adenosis

http://surgpathcriteria.stanford.edu/breast/lcis/

This site says (of LCIS): "neighboring terminal ducts usually show proliferation of similar appearing cells with pagetoid growth (continuous row beneath secretory epithelium), causing cloverleaf or necklace patterns" http://www.pathologyoutlines.com/breastmalignant.html#lcis

 Here's a picture

http://www.pathologyoutlines.com/images/mammary/179.jpg

But I don't think I could recognize pagetoid spread if my life depended on it....

If you aren't comfortable with your team, then I highly support the notion of checking out someone else, at least for comparasion.

I can't stand my BS, and I go to my onc for my exams.  I went to a major institution (NCI certified) for a 2nd opinion, and they were MUCH worse than my onc.  On some aspects, I knew more than the person at the major institution did.  My PCP knew more on some aspects than the major institution did.

I have gone to this same NCI certified institution for genetic counseling, and they were excellent.  I also went to this same NCI certified institution for another medical problem I have, and they  are/were excellent.  I graduated from this institution decades ago.  I was very disappointed with the high risk breast cancer consult I got there - they can't even find the consult!!

I'm a hospital pharmacist, and some of the oncs at the place I work are good, and some I wouldn't ever want to be their patient.  Some of the nurses say of these docs I can't stand and say their patients often love them.  I'm sure some of their patients do.  I just know how that doc treats the nurses and support staff.  They frighten the nurses so badly that  I know the nurses can't do a good job.

As in every profession, there are people who are good, and those that aren't so good.  There are also personality factors or style factors that are involved.  Dr. Susan Love, in her book, says that for breast surgeons, they did a survey, and found that the most satisfied patients were NOT the patients that understood most about their disease, but the patients where their style fit that of the surgeon.  Some surgeons and patients want the patient to have all the choice possible, and leaves it up to the patient; and other surgeons and  patients want more guidance. Its not good or bad, it just is.

But you need to have someone with which you can be comfortable.

You will probably feel rotten until you can at least compare your onc to other oncs.  Choice is good.

I was diagnosed with IDC 12/16/08.  Treatment was to be lumpectomy, sentinel node biopsy then radiation.  Another lesion was found on a pre-op MRI.  A stereotactic biopsy of that area was essentially benign however the BS was very concerned about the "Atypical lobular hyperplasia with Pagetoid extensions into ducts" on the Pathology report.  He said this was a rare finding and he wants to confer with the Oncologist, and radiologist, and bring it to the tumor board - so surgery is in limbo.  That didn't give me confidence.  I am ready for a second opinion and think I am ready for a mastectomy w/reconstruction.  Wouldn't that solve the problem?  I am anxious to get on with life.  Can anyone offer any advice and should I be really concerned about the Pagetoid extensions?

I had reconstruction and breast lift to correct breast asymmetry after 2 biopsies of my right breast. The surgeon did not order a mammo before the surgery. After the surgery the pathology report was LCIS with Pagetoid extension into a duct. The doctor only told me about the LCIS. I was sent to oncology immediately where I was told I should take Raloxifien. No tests were ordered to make sure there was nothing else growing in my breast.

In the meantime I moved to another state and found an oncologist. She looked at my records and immediately started a treatment plan. She said imaging should have been done. I am set up for mammo, ultrasound, genetic testing Tumor board review and apppt with a surgeon. I have elected to do a double mastectomy with reconstruction. It seems there are varying opinions about the significance of Pagetoid cells. Not sure what to believe. But I am glad I found an oncologist that cares