Some observations on Paget's disease of the nipple

HE ASSOCIATION of an eczematous condi-T tion of the nipple with a cancer of the terminal part of one or more lactiferous ducts -commonly known as Paget's disease of the nipple-has provided the stimulus for much investigation and speculation.Through the work of Muir,4 Inglis,3 and others, our present concepts of this condition have evolved.T h e Paget cells are regarded as migrant cancer cells derived frorn the growth in the terminal part of the lactiferous duct(s), which have invaded the epidermis by direct continuity (Fig. IA).Controversy has arisen, however, in respect of that group of cases in which, in addition to the terminally situated carcinoma, a second more deeply situated and often invasive growth is present within the breast substance.Difference of opinion exists as to whether this constitutes an independent lesion5 (Fig. 1B)From the Departinent of Surgery, University of the