This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Breast, Subject name: Surgery
A 40 years old female presented to OPD with this lesion in the breast. What is the most probable diagnosis? 
Select and explain. 
A. DCIS, B. LCIS, C. Peau-d-orange, D. Paget's disease of nipple
D: Paget's disease of nipple
Answer: D: Paget's disease of nipple 
Explanation: PAGET'S DISEASE is a superficial manifestation of an underlying breast carcinoma (95%) it presents as an eczema like condition of nipple and areola that persists despite treatment. Microscopically, Paget's disease is characterized by the presence of large, ovoid cells with abundant clear, pale staining cytoplasm in the Malpighian layer of epidermis. Treatment: mastectomy + axillary staging or wide local excision of nipple and areola to achieve clear margins, axillary sampling and radiation therapy. PEAU-D-ORANGE