Paget’s disease of the breast
DEFINITION
Paget’s (PAJ-its) disease of the breast is a rare form of breast cancer. Paget’s disease of the breast starts on the nipple and extends to the dark circle of skin (areola) around the nipple. Paget’s disease of the breast isn’t related to Paget’s disease of the bone, a metabolic bone disease.
Paget’s disease of the breast occurs most often in women older than age 50. Most women with Paget’s disease of the breast have underlying ductal breast cancer, either in situ — meaning in its original place — or, less commonly, invasive breast cancer. Only in rare cases is Paget’s disease of the breast confined to the nipple itself.
CAUSES
Doctors don’t know what causes Paget’s disease of the breast. The most widely accepted theory is that the disease results from an underlying ductal breast cancer. The cancer cells from the original tumor then travel through milk ducts to the nipple and its surrounding skin. Another theory is that the disease can develop independently in the nipple.
SYMPTOMS
Paget’s disease of the breast affects your nipple and usually the skin (areola) surrounding it. It’s easy to mistake the signs and symptoms of Paget’s disease of the breast for skin irritation (dermatitis) or another noncancerous (benign) skin condition.
Possible signs and symptoms of Paget’s disease of the breast include:
- Flaky or scaly skin on your nipple
- Crusty, oozing or hardened skin resembling eczema on the nipple, areola or both
- Itching
- Redness
- A tingling or burning sensation
- Straw-colored or bloody nipple discharge
- A flattened or turned-in (inverted) nipple
- A lump in the breast
- Thickening skin on the breast
Signs and symptoms usually occur in one breast only. The disease typically starts in the nipple and may spread to the areola and other areas of the breast.
The skin changes may come and go early on, or respond to topical treatment, making it appear as if your skin is healing. On average, women experience signs and symptoms for several months before getting a diagnosis.
When to see a doctor
Check your nipple and areola on both breasts on a regular basis, such as during breast self-exams. If you feel a lump, or if you experience itching or skin irritation that persists for more than a month, see your doctor.
If you’re being treated for a skin injury on your breast, and the condition doesn’t go away with treatment, make a follow-up appointment with your doctor. You may need a biopsy — a procedure that collects a small tissue sample for microscopic analysis — to evaluate the affected area.
