E-ISSN 2757-8062
Volume : Issue : Year : 2022

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Zeynep Kamil Medical Journal
Nipple reconstruction with skate flap technique after central lumpectomy in Paget's disease located on the nipple [Zeynep Kamil Med J]
Zeynep Kamil Med J. Ahead of Print: ZKMJ-92499

Nipple reconstruction with skate flap technique after central lumpectomy in Paget's disease located on the nipple

Sami Acar1, Sezer Çetin2
1Zeynep Kamil Women and Children’s Diseases Training and Research Hospital, Department of General Surgery
2Zeynep Kamil Women And Children’s Diseases Training And Research Hospital, Departman Of Obstetrics And Gynecology

Background
Paget's disease of the breast is a pathological condition that causes long-term complaints in the nipple-areola complex (NAC). It is characterized by eczematous changes in the nipple. There are two theories of its pathogenesis. According to the transformation theory, it is suggested that epidermal keratinocytes in the nipple turn into malignant Paget's cells. The epidermotropic theory that generally accepted holds that Paget's cells are ductal adenocarcinoma cells that have migrated to the nipple epidermis. The underlying breast lesion is usually ductal carcinoma in situ (DCIS), but invasive cancer can also be found. Since the clinical manifestations are very similar to many common skin rashes that a woman has experienced in her life, the diagnosis can easily be overlooked or misdiagnosed. While the traditional treatment for Paget's disease is mastectomy; in appropriate cases, the use of radiotherapy in combination with breast-conserving surgery comes to the fore. Due to the rarity of the disease and the lack of prospective randomization of studies, the standard protocol could not be established.
Case
It is aimed to present the treatment process of our patient who was admitted with a complaint of a non-healing nipple wound for a long time and was diagnosed with Paget's disease of the breast as a result of breast-preserving surgery. Skate flap technique was preferred for nipple reconstruction after central lumpectomy, and there was no loss of projection after radiotherapy.
Conclusion
NAC is an important anatomical part of the breast and its cosmetic appearance is significantly affected in the case of surgical excision. The fact that the cosmetic appearance is at the desired level is valuable for the quality of life. For this reason, in cases requiring central lumpectomy, efforts should be made for nipple reconstruction.

Keywords: Mammaplasty, nipple, Paget’s disease, reconstructive surgical procedures



Corresponding Author: Sami Acar, Türkiye
Manuscript Language: English
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