Ans. is 'b' i.e., Pagets disease of breast treated by wide excisiono Paget's disease of nipple is a chronic eczematous eruption of nipple which may progress to an ulcerated weeping lesion. It is almost always associated with an underlying ductal carcinoma (may be in situ Ca or invasive),o The underlying lesion may be palpable or not.o A complete mammographic workup and biopsy of the nipple and underlying mass if present is done,o Pathognomonic histological feature is presence of Paget's cells in the epithelium. A skin specimen containing cells confirms the diagnosis and can be obtained by nipple scrape cytology or biopsy.o Paget's disease may be confused w'ith superficial spreading melanoma. Differentiation from pagetoid intraepithelial melanoma is based on the presence of S-100 antigen immunostaining in melanoma and carcinoembryonic antigen immunostaining in Paget's disease.Treatment of Paget's disease includes :Mastectomy + axillary staging (axillary dissection or sentinel node biopsy)Wide excision of the nipple and areola to achieve clear margins + radiation + axillary staging, orLumpectomy + radiation therapy + axillary lymph node procedureo Paget's disease of nipplePaget's disease of the breast is a superficial manifestation of an underlying breast carcinoma.The underlying breast carcinoma is intraductal carcinoma.It presents clinically as a chronic eczematous eruption of nipple, which may be subtle but may progress to an ulcerated, weeping lesion.Paget's disease usually is associated w'ith extensive DC1S and may be associated with an invasive cancer. The carcinoma may or may not be palpable.A complete mammographic w'orkup and biopsy of the nipple and underlying mass if present is done.Pathognomonic histological feature is presence of Paget's cells in the epithelium. Paget's cells are large pale vacuolated cells. A skin specimen containing cells confirms the diagnosis and can be obtained by nipple scrape cytology or biopsy."There is no survival advantage for mastectomy over breast preservation ". Sabiston 18,h/e p. 874