Paget’s disease breast is a rare form of cancer that affects the skin of the nipple and areola. It is usually associated with cancer of the underlying milk ducts. This cancer is called ductal carcinoma in situ (DCIS). It’s not the same as invasive breast cancer, which occurs when cancer cells break through the tissue that lines the breast ducts and spread throughout the body.
People with Paget’s disease have a very low risk of developing invasive breast cancer. This type of cancer has a better chance of being treated than most other types of breast cancer. It’s important for doctors to recognize and diagnose this condition. It’s also important to learn how to prevent it.
Symptoms of Paget’s disease include itching, flaking and scaling of the skin on the nipple and areola. The rash may look crusty or scaly and can be red or pink. It may ooze or have a yellow discharge, or it may be weeping. Sometimes, the nipple may change shape or become flat or inverted.
If you have these symptoms, it’s important to see your doctor right away. Your doctor can give you medicine to treat the rash or refer you for a biopsy.
Doctors don’t know what causes Paget’s disease breast. They think it might happen when cancer cells from a tumor in the breast ducts move to the nipple and areola. But it’s also possible for cancer cells to move to the nipple and isola on their own.
Most cases of Paget’s disease breast develop in women who were assigned female at birth. However, it has been reported in men as well. It affects people in their 50s, 60s and older. The rash can progress slowly over months and becomes scaly or fissured. The rash can then appear as clearly demarcated, eczema-like plaques on the nipple and areola.
In 80%-90% of cases, Paget’s disease breast is found along with DCIS. This is true even when the nipple lump is not palpable. In some people, the nipple rash can become more serious and spread to other parts of the body. This is called invasive breast cancer.
Doctors can find Paget’s disease breast by examining the skin of your nipple and areola under a microscope. They can also use imaging tests such as a mammogram or ultrasound to check for breast calcifications and other abnormalities.
When you have a mammogram or ultrasound, a doctor will take a small sample of the nipple and areola to make a diagnosis. The tissue is sent to a laboratory for further testing.
The type of treatment you get depends on the results of your biopsy and the type of breast cancer that’s present. If you have a noninvasive cancer, your doctor might suggest surgery to remove the lump and the lining that covers the chest muscles. They might also recommend chemotherapy and/or radiation. If you have invasive cancer, your doctor might perform a mastectomy. This involves removing the entire breast and a portion of the skin under it. Your doctor might also suggest a lumpectomy.
