Paget's disease

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This is Sir James Paget, who, in the name of science, volunteered to examine a hell of a lot of breasts.

What is Paget's disease?

There are two types, affecting different parts of the body!

Who was Paget?

Sir James Paget, 1st Baronet (11 January 1814 – 30 December 1899) was a British surgeon and pathologist who is best remembered for Paget's disease and who is considered, together with Rudolf Virchow, as one of the founders of scientific medical pathology. His famous works included Lectures on Tumours (1851) and Lectures on Surgical Pathology (1853). While most people recall that Paget's disease refers to bone, there were actually three diseases named after him: Paget's disease of bone, Paget's disease of the nipple (a form of intraductal breast cancer spreading into the skin around the nipple), and Extramammary Paget's disease. Also named for him is Paget's abscess.

Paget's disease of bone

A condition of bone metabolism - this is the common one they are usually talking about. The metabolism of bone is massively sped up, so bone is broken down and rebuilt too fast, leading to poor structure. You measure alkaline phosphatase, and if its raised, and a bone scan confirms it, give them bisphosphonates (same as for osteoporosis).

Paget's disease of breast

A cancer of the nipple, that almost always implies there is an underlying breast cancer. That's really about it. Very rare on its own, so generally a sign for other cancer. Looks a bit like eczema, an itchy red rash, can begin to bleed and ulcerate, and the nipple can invert.