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Paget’s Disease

Paget’s disease is a malignant rash of the skin of the nipple or areola. It is a rare condition accounting for only one percent of breast cancers.

Paget’s disease may be associated with ductal carcinoma in situ (DCIS) or invasive cancer deeper in the breast. 

What are the symptoms of Paget’s disease?

  • Redness and irritation of the nipple and/or areola
  • Crusting and scaling of the nipple area
  • Bleeding from the skin of the nipple/areola
  • Oozing from the nipple/areola
  • Burning and/or itching of the nipple/areola

How is Paget’s disease diagnosed?

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Most nipple rashes are simply a minor skin infection or a reaction to some irritant.  A nipple rash that does not get better with topical treatments requires biopsy.  This is done by anesthetizing the nipple and areola with local anesthetics and then taking a small sample of the affected skin (punch biopsy).

After Paget’s disease is diagnosed by nipple skin biopsy, the evaluation will continue with mammography and possibly ultrasound or MRI to look for an underlying breast cancer. 

Because of the skilled expertise of our pathologists who specialize in breast cancer, we are able to accurately diagnose Paget’s disease. As with any cancer, early detection and diagnosis results in better outcomes for the patient. Despite the rarity of this type of breast cancer, the specialists at our Breast Center are experienced in managing the evaluation and treatment of this disease.

Learn more about the steps of diagnosis, including:

What is the treatment for Paget’s disease?

If the breast cancer is limited to Paget’s disease, treatment includes the surgical removal of the nipple and areola, as well as a margin of healthy tissue around the areola. A central breast resection will generally preserve the shape and size of the breast and the nipple can be reconstructed later. In some cases, mastectomy may be recommended. Your physician may recommend a combination of any of the following:

  • Central breast resection – this involves removal of the nipple and areola  along with a sufficient amount of tissue underneath to ensure removal of the cancer cells. It is usually followed by radiation.
  • Mastectomy
  • Radiation therapy
  • Hormonal therapy

What is the prognosis for Paget’s disease?

If the biopsy shows DCIS, stage 0 cancer and no invasive cancer, the prognosis is excellent.