Paget's disease of the breast

Paget's disease of the breast, often referred to as Paget’s disease of the nipple, is a rare type of breast cancer that affects the skin on your nipple. It’s often mistaken with a skin condition but is often actually a sign of cancer in the milk ducts.

If you notice any unusual changes in your nipple or breast skin, seek medical advice immediately. Early detection and treatment are crucial for managing this disease effectively.

Our breast cancer specialists at Advocate Cancer Institute are here for you. From genetic testing to access to clinical trials, we offer the most comprehensive cancer care in Illinois.

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Paget's disease of the breast symptoms

Early symptoms of Paget’s disease of the breast might be subtle and easily ignored. Regular self-exams and monitoring for any changes in the skin of your nipple and areola can aid in early detection, improving the chances of successful treatment.

Here are the main signs to look out for:

• Skin changes in the nipple and areola: You might see redness, flaking or crusting of the skin on your nipple and areola. These symptoms can be mistaken for eczema but don’t improve with typical skin treatments.
• Nipple discharge: There may be a yellowish or bloody discharge from your nipple.
• Persistent itching or tingling: A continuous itching or tingling sensation in the nipple and areola area can be a warning sign.
• Nipple retraction: The nipple might become flattened or turned inward.
• Breast lump or thickening: Sometimes, there can be a palpable lump in the breast, suggesting an underlying mass.

How fast does Paget's disease of the breast develop?

The progression of Paget's disease of the breast can vary widely. It can develop slowly over several months or years. It can also progress more quickly, especially if associated with underlying invasive breast cancer.

Risk factors of Paget's disease of the breast

Paget's disease of the breast is uncommon, but certain factors may increase your risk, such as:

• Age: It's most frequently diagnosed in women over 50.
• History of breast cancer: A personal or family history of breast cancer can increase your risk.
• Genetic mutations: Mutations in genes like BRCA1 and BRCA2 can elevate your risk.
• Radiation exposure: Previous radiation treatment to the chest area is a risk factor.
• Hormone replacement therapy (HRT): Long-term use of hormone replacement therapy after menopause has been linked to a higher risk.

Diagnosing Paget's disease of the breast

Diagnosing Paget's disease of the breast involves several steps. Your doctor will perform a series of tests to confirm the diagnosis, including:

• Clinical breast exam: A physical examination of the breasts to check for lumps, skin changes and nipple discharge.
• Mammogram: An imaging test to detect abnormalities in breast tissue. However, Paget’s disease may not always be visible on a mammogram.
• Ultrasound: This test provides detailed images of the breast tissue and can help identify any underlying masses.
• Biopsy: The definitive diagnosis is made through a biopsy, where a sample of skin or tissue from the nipple and areola is examined under a microscope.

Paget's disease of the breast treatment

Treatment for Paget's disease of the breast typically involves addressing both the disease in the nipple area and any underlying breast cancer. The main treatment options include:

• Surgery: This is a common treatment method. Options include mastectomy, which removes the entire breast, or breast-conserving surgery, like a lumpectomy, which removes the affected tissue while preserving the rest of the breast.
• Radiation therapy: Often used after surgery, radiation therapy helps destroy any remaining cancer cells and reduce the risk of recurrence.
• Chemotherapy: If there is invasive breast cancer, chemotherapy might be necessary to treat cancer throughout the body.
• Hormone therapy: For hormone receptor-positive cancers, hormone therapy can help by blocking the hormones that fuel cancer growth.
• Targeted therapy: Specific drugs that target characteristics of cancer cells can be effective for certain types of breast cancer.

Your care team at Advocate Health Care will use a collaborative approach to provide the best treatment possible. We also offer supportive care services such as counseling, nutrition therapy, palliative care and physical therapy that may be beneficial to help you manage the physical and emotional challenges of cancer treatment.