Paget Disease Of The Breast

• Paget Disease Of The Breast is a rare cancer affecting the nipple and areola, often linked to underlying breast cancer.
• Symptoms frequently include redness, scaling, itching, or crusting of the nipple, commonly on one side.
• Diagnosis typically involves a physical exam, imaging, and a biopsy of the affected skin.
• Treatment usually includes surgery, often followed by additional therapies like radiation, chemotherapy, or hormone therapy.
• Early detection is vital for improving outcomes, highlighting the importance of recognizing persistent nipple changes.

What is Paget Disease Of The Breast?

Paget Disease Of The Breast is a rare type of cancer that begins in the milk ducts and spreads to the skin of the nipple and areola. It accounts for approximately 1% to 4% of all breast cancer cases, according to the American Cancer Society. This condition is characterized by the presence of Paget cells, which are cancerous cells found in the epidermis of the nipple and surrounding skin. While it primarily affects the nipple, it is almost always associated with an underlying breast cancer, either ductal carcinoma in situ (DCIS) or invasive ductal carcinoma, within the breast itself.

The disease typically manifests as skin changes on the nipple and areola, which can be easily confused with non-cancerous skin conditions such as eczema or dermatitis. Understanding its distinct characteristics is essential for differentiating it from these benign conditions and ensuring timely medical intervention.

Signs, Symptoms, and Diagnosis of Paget Disease Of The Breast

Recognizing the specific **Paget disease breast symptoms and signs** is critical for early detection. These symptoms usually affect only one nipple and may persist despite topical treatments for common skin conditions. The appearance of the nipple and areola can vary, but common indicators include:

• Redness, scaling, or crusting of the nipple and areola
• Itching, tingling, or burning sensation in the nipple area
• Flaking or thickening of the nipple skin
• Oozing or bleeding from the nipple
• A flattened or inverted nipple
• A palpable lump in the breast (in about half of cases)

The process of **diagnosing Paget disease of the breast** typically begins with a thorough physical examination of the breast and nipple. If Paget disease is suspected, imaging tests such as mammography and ultrasound are usually performed to look for an underlying tumor within the breast. Magnetic resonance imaging (MRI) may also be used for further evaluation. The definitive diagnosis, however, relies on a biopsy of the affected nipple or areola skin. This involves taking a small tissue sample to be examined under a microscope for the presence of Paget cells. If an underlying mass is detected, a core needle biopsy of the mass will also be performed.

Treatment Options for Paget Disease Of The Breast

The **treatment for Paget disease of the breast** is primarily surgical, aiming to remove the affected nipple and areola, as well as any underlying breast cancer. The choice of surgical procedure depends on the extent of the disease and the presence of an underlying tumor. Historically, mastectomy (removal of the entire breast) was the standard approach. However, for some patients, breast-conserving surgery (lumpectomy) followed by radiation therapy may be an option, particularly if the underlying cancer is small or limited to ductal carcinoma in situ and can be completely removed with clear margins.

In addition to surgery, adjuvant therapies may be recommended based on the characteristics of the underlying breast cancer, such as its size, grade, hormone receptor status, and HER2 status. These therapies can include chemotherapy, hormone therapy (for hormone receptor-positive cancers), or targeted therapy (for HER2-positive cancers). Lymph node evaluation, often through sentinel lymph node biopsy, is also a crucial part of treatment planning, especially if invasive cancer is present. A multidisciplinary team of specialists, including surgeons, oncologists, and radiation oncologists, works together to develop a personalized treatment plan for each patient, ensuring the most effective management of this complex condition.