Background and purpose: Paget’s disease (PD) of the breast is a rare disease. The survival of PD was reported to be related to the characteristics of the underlying carcinoma. This study aimed to investigate the characteristics and survival of PD patients with underlying invasive breast carcinoma (IBC). Methods: Fifty-four patients diagnosed with PD and an associated IBC in Fudan University Shanghai Cancer Center from 2002 to 2007 were recruited in this study as study group. Since most PD overexpress HER-2

72 patients with HER-2-overexpressing breast cancer were randomly recruited as control group. This study compared survival between these two groups. Results: Twenty-five (46.3%) patients in study group had no clinical manifestation of PD and were diagnosed unexpectedly by a histologic examination. Thirty-five (64.8%) patients in study group had tumors larger than 2 cm

twenty-six(48.1%) patients in study group had chance of axillary lymph node involvement. Compared with control group

patients in study group tended to have more events (5-year relapse-free survival: 76.4% vs 48.5%

P0.01). In the control group

most events occurred in the first 3 years after operation

while recurrence might happen all along in the 5 years after operation in study group. Patients in study group also had a poorer overall survival than in control group (61.0% vs 80.6%

P=0.01). Conclusion: Patients with Paget’s disease and underlying invasive breast cancer tend to have poorer survival than those with HER-2-overexpressing breast cancer.