Paget Disease Of The Breast

What Paget Disease of the Breast Means

Paget disease of the breast is a rare type of breast cancer that specifically affects the skin of the nipple and usually the areola, which is the darker skin surrounding the nipple. It is not just a skin problem but a form of cancer that often signals the presence of other breast cancers inside the breast. The cancer cells may start in the nipple or travel from a tumor deeper in the breast through the milk ducts to the nipple area.

Why It Matters in Cancer Care

This disease is important because it often occurs alongside other breast cancers, such as ductal carcinoma in situ (DCIS), an early, non-invasive breast cancer, or invasive breast cancer that has spread beyond the milk ducts. Recognizing Paget disease early can help guide treatment and improve outcomes. Because it is rare and its symptoms can look like common skin conditions, early diagnosis is key to managing the disease effectively.

Symptoms and What Patients Might Notice

People with Paget disease of the breast may notice symptoms that can look like common skin problems such as eczema or dermatitis. These include itching, tingling, redness, flaking, crusty or thickened skin on or around the nipple, a nipple that looks flattened, and sometimes yellowish or bloody discharge. There may also be a lump or tumor in the breast. Because these signs can resemble less serious skin conditions, it is important to have any persistent nipple changes checked by a healthcare provider.

Diagnosis and Testing

Doctors diagnose Paget disease through a combination of physical exams, imaging tests such as mammograms, breast ultrasounds, or MRI scans, and skin biopsies. A biopsy involves removing a small sample of skin or tissue from the nipple or areola to look for cancer cells. If cancer cells are found in the nipple skin but no tumor is seen inside the breast, the diagnosis may be stage 0 breast cancer (DCIS). However, sometimes invasive cancer is also present and needs careful evaluation. Additional tests may check for hormone receptors and other markers to help guide treatment.

Treatment Options

Treatment depends on whether the cancer is limited to the nipple area or has spread inside the breast. If only DCIS is present, treatment may involve surgery to remove the nipple and affected tissue, sometimes followed by radiation. If invasive breast cancer is found, treatment will follow standard approaches for invasive breast cancer, which may include surgery, radiation, hormone therapy, chemotherapy, or targeted therapies.

Common Confusions and Related Terms

Paget disease of the breast is also called mammary Paget disease or Paget disease of the nipple. These terms all refer to the same condition. It is important not to confuse this disease with Paget disease of the bone, which is a different condition. Because symptoms resemble common skin issues, patients may initially think they have eczema or dermatitis. Understanding the difference and seeking medical advice is important.

Questions to Ask Your Care Team

If you or a loved one is diagnosed with Paget disease of the breast, it can help to ask your doctor about the presence of any tumors inside the breast, the results of biopsy tests, and what treatment options are recommended. You might also want to ask how the diagnosis affects your breast cancer risk, what tests will be done to check for spread, and how treatment might affect breast appearance and function.

Next Steps and Safety

This information is meant to help you understand Paget disease of the breast but cannot replace personalized medical advice. Every person’s situation is unique, so it is important to discuss your specific diagnosis and treatment plan with your healthcare team. If you notice any changes in your nipple or areola, such as redness, itching, flaking, or discharge, it is important to see your doctor promptly. Early evaluation and diagnosis can lead to better treatment options and outcomes.