**Question:** Treatment for Paget's disease of breast is

A. Radiotherapy
B. Hormone therapy
C. Surgical excision
D. Chemotherapy

**Core Concept:**
Paget's disease of the breast is a rare, extramammary Paget's disease that affects the nipple and areola, resulting from intraepithelial spread of underlying breast cancer. This disease is characterized by skin erosion, crusting, and pruritus.

**Why the Correct Answer is Right:**
The correct answer is **C.** Surgical excision (mastectomy or wide local excision) is the primary treatment for Paget's disease of the breast. This approach allows for complete removal of the affected breast tissue, including the nipple-areolar complex, to prevent cancer spread and recurrence. Additionally, radiation therapy (radiotherapy) may be used as an adjuvant therapy to reduce the risk of local recurrence.

**Why Each Wrong Option is Incorrect:**

A. Radiotherapy is important as an adjuvant therapy, but the primary treatment option for Paget's disease of the breast is surgical excision.
B. Hormone therapy is not typically chosen for the primary treatment as it is more commonly used for hormone receptor-positive breast cancer, not Paget's disease itself.
D. Chemotherapy is used for systemic treatment of breast cancer but is not the primary treatment for Paget's disease of the breast.

**Clinical Pearl:**
In cases of Paget's disease of the breast, the surgeon's perspective is crucial, as surgical excision allows for histopathological assessment of the tissue to confirm the diagnosis and guide further management, including radiation therapy (radiotherapy) or hormone therapy when indicated. A multidisciplinary approach involving surgeons, oncologists, and dermatologists is essential for optimal management of this challenging condition.