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What is Paget's Disease of the Breast?

By D. Jeffress
Updated Mar 03, 2024
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Paget's disease of the breast is a type of cancer that manifests on and underneath the nipples. It is one of the rarest varieties of breast cancer, and it almost never occurs alone. Rather, Paget's disease is usually accompanied by a more common type of underlying cancer deeper within the breast. Tumors can cause chronic pain, fatigue, and eczema-like symptoms around the nipples. Non-surgical treatment options are limited, and most cases require mastectomy to ensure the cancer does not spread to lymph nodes and other parts of the body.

A woman of any post-pubescent age can suffer from this condition, but the majority of patients are over the age of 50. Very rarely, the cancer may develop in older men. Doctors are unsure what causes Paget's disease, but it is believed that both genetic and environmental factors play important roles. Exposure to high levels of radiation, as can occur during treatment for other cancers, may trigger Paget's disease of the breast. Obesity, high levels of estrogen hormones, and familial history of breast cancer also put women at an increased risk.

Paget's disease of the breast is a relatively quick-growing cancer, but physical symptoms may not be apparent for several months after a tumor starts to develop. The first signs of cancer can include tenderness, redness, and dryness around the nipple. The skin starts to flake and itch, and the nipple can flatten or appear inverted. Occasionally, a hard lump can be felt behind the nipple. Paget's disease is usually isolated to one breast, but it is possible to have symptoms in both breasts at a time or later develop the cancer on the other side.

A woman who notices changes to her breast should visit a doctor as soon as possible to receive a proper diagnosis. A specialist can perform a physical examination to evaluate the nipple's appearance and check for lumps. Mammograms are performed to look for underlying tumors deeper in the breast. If Paget's disease is suspected, the doctor can scrape a small sample of tissue from the nipple for laboratory analysis.

Once a diagnosis is confirmed, specialists can begin considering different treatment options. Surgery is usually necessary to remove part or all of the affected breast. If there is no underlying cancer, just the nipple and milk ducts can be excised. In most cases, however, the entire breast needs to be removed. If Paget's disease of the breast spreads to the lymph nodes in the armpits, they are taken out as well.

When cancer is detected and treated early, most women experience full recoveries following surgery. Padded bras and custom orthotics can be used to return symmetry to the chest. If tumors develop elsewhere the body after treatment, long-term chemotherapy or radiation may be needed to reduce the risk of fatal complications.

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Discussion Comments
By amypollick — On May 21, 2013

@anon335508: Definitely have your mammogram and check-up, but try this also. Instead of using the eczema cream, try washing the affected area with a collodial oatmeal soap, like Aveeno, and then using something like Sea Breeze or even rubbing alcohol on it. It will probably burn like the dickens, but try it anyway.

I say this because it sounds like you could have what's called "interigo," which is a rash that occurs in skin folds. Often, it's caused by the candida fungus, so it's something like a yeast infection. The collodial oatmeal soap helps heal the skin, and the alcohol makes the environment not conducive to the stuff spreading.

Just try it for a couple of days and see if you notice any improvement. Good luck!

By anon335508 — On May 21, 2013

I have itching around both breasts, not just on the nipple. It seems to be eczema, but I'm not positive. There are now these pimple like bumps only on the right nipple with the raw sores down my cleavage and around the under part where it gets sweaty.

I have a mammogram in two weeks so I will bring it up there. Until then, tons of prayers and eczema cream. If it does not help then I know it is something worse.

By anon160458 — On Mar 15, 2011

my nipples have been inverted for about two years along with itchy nipples. Just recently I found a lump just below my nipple in my right breast. I see my OB//GYN this Thursday. If I do have pagets disease, with these symptoms for two years, could I have waited too long?

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