What is Paget’s disease of the breast?
Paget’s disease of the breast is a rare type of breast cancer that primarily affects the skin of the nipple and, often, the areola. It is associated with underlying breast cancer, usually ductal carcinoma in situ (DCIS) or invasive breast cancer. The condition often appears as eczema-like changes on the nipple but is unrelated to the common skin condition eczema.
What are causes and risk factors of Paget’s disease of the breast
The exact cause of Paget’s disease of the breast is not fully understood, but it is believed to occur when cancer cells from underlying breast cancer travel through the milk ducts to the nipple surface.
Factors that increase the risk of Paget’s disease of the breast are similar to those for other forms of breast cancer, including:
- Age, more common in older adults
- Personal or family history of breast cancer
- Genetic mutations, such as BRCA1 or BRCA2
What are symptoms of Paget’s disease of the breast?
Symptoms affect your nipple and/or areola and may come and go at first but eventually worsen. Symptoms may resemble certain skin conditions like eczema or dermatitis, making it difficult to diagnose. Common signs include:
- Redness, flaking or scaling of the nipple skin
- Itching, tingling or burning sensation in the nipple
- Nipple discharge, possibly yellowish or bloody
- Flattened or inverted nipple
- A lump in the breast
How is Paget’s disease of the breast diagnosed?
To diagnose Paget’s disease of the breast, your provider will take a sample of nipple tissue to examine under a microscope. After identifying the disease, they will need to find out if you have underlying ductal carcinoma, which is done by examining your breast tissue with imaging tests, such as a mammogram or breast ultrasound. If they find an area suspicious, they may need a needle biopsy to take a sample of the breast tissue.
What are treatment options for Paget’s disease of the breast?
Treatment for Paget’s disease of the breast depends on the presence and extent of underlying breast cancer. Any cancer in your breast will need to be surgically removed. A mastectomy is the removal of the entire breast, often recommended if there is invasive cancer. Breast-conserving surgery removes the tumor and affected nipple with radiation therapy.
After surgery, you will likely have additional treatments to prevent the cancer from recurring. These can include:
- Radiation therapy
- Chemotherapy
- Hormone therapy
- Immunotherapy
What is the prognosis of Paget’s disease of the breast?
Breast cancer survival is based on the stage of the cancer when it is detected. If your cancer is in stage 0 and hasn’t spread beyond the milk ducts, most people make a full recovery. Once breast cancer begins to spread, it becomes progressively harder to beat.
If you notice persistent changes in your nipple or areola, such as redness, flaking, or discharge, consult your healthcare provider immediately. Early evaluation can lead to timely diagnosis and treatment.