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Invited Critique
Nov 2011

Paget's Disease: A Potential Predictor of Breast Cancer Survival? Comment on “Effect of Paget's Disease on Survival in Breast Cancer”

Author Affiliations

Author Affiliations: Department of Surgery, The Johns Hopkins University, Baltimore, Maryland.

Arch Surg. 2011;146(11):1271. doi:10.1001/archsurg.2011.277

The rarity of PD makes its prognostic significance largely unknown. Most investigations of PD rely on database analysis. A disadvantage of this approach is not having a clear definition of the diagnosis with distinction between adenocarcinoma within the epidermis of the nipple as opposed to retroareolar invasion. This need was addressed by pathological review in the study by Ortiz-Pagan and colleagues.1 Cases and controls were matched for stage, age at diagnosis, and year of treatment. In the statistical analysis, the authors attempted to adjust for extent of treatment and biological markers, but that adjustment was limited by the sample size.

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