Toker Cell Hyperplasia Vs Paget’s Disease of Breast: A Diagnostic Dilemma

Toker cell hyperplasia (TCH) is a benign proliferation of clear epithelial cells within the nipple epidermis that can closely mimic mammary Paget’s disease on histology, creating a significant diagnostic challenge. Accurate distinction relies on careful morphologic assessment and immunohistochemistry, with TCH typically expressing CK5/6 and lacking HER2 overexpression. Emerging evidence suggests an increased prevalence in transmasculine individuals receiving long-term testosterone therapy, indicating a possible hormonal influence.