ABSTRACT
Pigmented mammary Paget's disease is a rare variant of mammary Paget's disease, and this mimics malignant melanoma both clinically and histopathologically. Two women aged 48 and 44 years old, respectively, presented with 2-cm pigmented patches and 1-cm pigmented erosive crusted papules without discharge or palpable masses, respectively. They had previously undergone breast-conserving surgery following the diagnosis of intraductal carcinoma of the breast. Physical examinations and imaging studies revealed no evidence of the recurrence of breast cancer. However, histopathological and immunohistochemical analyses demonstrated the presence of 1) Paget's cells in the epidermis and these cells contained melanin within their cytoplasm and 2) numerous melanophages in the upper dermis. We diagnosed the two patients with pigmented Paget's disease. Subsequent pathological analyses revealed recurrent intraductal carcinoma. We recommend that skin biopsies should be taken from patients presenting with pigmented lesions of the nipple, who have previously undergone breast-conserving treatment, to test the possibility of cancer recurrence.