Understanding Paget's Disease of the Breast: Symptoms, Causes, Diagnosis, and Treatment

Paget's disease of the breast is a rare type of breast cancer that affects the nipple and the surrounding area (areola). It accounts for 1% to 4% of all breast cancer cases and is often associated with an underlying breast cancer, such as ductal carcinoma in situ or invasive breast cancer.

Symptoms of Paget's Disease of the Breast

The early symptoms of Paget's disease of the breast may include:

• Redness, scaling, and flaking of the skin on the nipple

• Mild irritation or itching of the nipple

• Increased sensitivity or burning sensation in the nipple

As the disease progresses, you may notice:

• Bloody or yellowish discharge from the nipple

• Oozing or bleeding areas on the nipple or areola

• A flattened or inverted nipple

• Thickened skin in the nipple area

• A lump or mass in the breast

Causes of Paget's Disease of the Breast

The exact cause of Paget's disease of the breast is unknown. However, one theory suggests that cancer cells from a tumor in the breast travel through the milk ducts and into the nipple and areola, causing the characteristic symptoms.

Diagnosing Paget's Disease of the Breast

To diagnose Paget's disease of the breast, your doctor will perform a biopsy, which involves taking a small sample of tissue from the nipple for laboratory analysis. Additional tests may include:

• Physical examination

• Mammogram (breast X-ray)

• Breast MRI

• Breast ultrasound

Treatment Options for Paget's Disease of the Breast

Treatment for Paget's disease of the breast depends on the presence and extent of any underlying breast cancer. Options may include:

• Mastectomy (removal of the entire breast)

• Lumpectomy (removal of the nipple, areola, and affected breast tissue)

• Radiation therapy

• Chemotherapy

• Hormonal therapy (for hormone receptor-positive cancers)

It's essential to discuss the potential side effects and long-term complications of cancer treatment with your healthcare provider. These may include pain, numbness, swelling, bone loss, infertility, heart problems, blood clots, or the development of new cancers.

Preventing Paget's Disease of the Breast

While there is no guaranteed way to prevent Paget's disease of the breast, certain lifestyle changes may help reduce your overall risk of breast cancer. These include maintaining a healthy weight, engaging in regular exercise, limiting alcohol consumption, and breastfeeding.

If you have one or more risk factors for breast cancer, talk to your doctor about additional steps you can take, such as genetic testing, more frequent screenings, preventive medications, or prophylactic mastectomy.

Outlook and Survival Rates

The outlook for Paget's disease of the breast depends on factors such as the presence and stage of any underlying breast cancer and whether the cancer has spread to nearby lymph nodes. According to data from 1988 to 2001, about 83% of women in the United States diagnosed with Paget's disease of the breast survived for at least five years, compared to 87% of women diagnosed with any type of breast cancer during the same period.

For more information on Paget's disease of the breast and breast cancer in general, visit the Breastcancer.org website or consult with your healthcare provider.

The Bottom Line

Any persistent nipple changes—especially scaling, redness, or bloody discharge—warrant immediate medical evaluation since early detection dramatically improves outcomes. Don't wait for symptoms to worsen, as this condition often indicates more extensive breast cancer requiring prompt treatment. If you're experiencing concerning nipple symptoms, Doctronic can help connect you with appropriate care quickly.