​Paget's Disease of the Nipple

What is Paget's Disease of the Nipple?

Paget's disease, sometimes referred to as Paget's disease of the breast, usually begins in the ducts of the nipple and spreads to the surface of the nipple and to the areola (the dark circle of skin around the nipple).

Instead of a lump, people usually notice fluctuating redness and irritation.

» See more symptoms of Paget's disease.

Often, Paget's disease accompanies another type of cancer within the breast. It usually occurs in one breast only.

Paget's disease of the nipple is rare; it accounts for approximately one percent of all cases of breast cancer.

Who's at risk for Paget’s disease of the nipple?

Anybody can develop Paget's disease of the nipple, but certain factors may increase your risk, including:

• If you are over the age of 50
• A family history of breast cancer
• A history of nipple crusting, scaling, itching, or inflammation

Learn more about the High-Risk Breast Cancer Program at Magee.

Symptoms and Diagnosis of Paget's Disease of the Nipple

Symptoms of Paget's disease of the nipple

Talk to your doctor if you notice any of the following symptoms:

• Aching or tenderness of the breast
• A dimpled, puckered, or "orange-peel" appearance in the skin
• Discharge from the nipple, especially if bloody or yellowish
• A nipple that turns inward
• Red or inflamed skin on the breast, nipple, or areola (the dark circle of skin around the nipple)
• Scaly and thickened skin on the breast
• Tingling or itching

Paget's disease of the nipple is often mistaken for:

• Eczema — a type of skin rash
Mastitis — an breast infection associated with breastfeeding
• Other inflammatory conditions

If you're being treated for eczema or mastitis — and the treatment isn't working — ask your doctor about Paget's disease of the nipple.

Testing for and diagnosing Paget's disease

Experts at the Magee-Womens Breast Cancer Program use a variety of tests and procedures to diagnose and screen for breast cancer, including:

Test	Description
Ultrasound (sonography)	A noninvasive test using high-frequency sound waves to produce real-time pictures of tumors.
Magnetic resonance imaging (MRI)	An imaging technique using a computer, a magnetic field, and radio waves to produce images of the body's soft tissues.
Mammogram with computer-aided detection (CAD)	An imaging procedure of the breast using low-energy x-rays to screen for or detect breast cancer and other abnormalities. A digital mammogram uses a phosphor plate, rather than film, to view mammography images. CAD is software that highlights tissue abnormalities in a mammogram.
3D mammogram (tomosynthesis)	An imaging tool using low-energy x-rays to create a 3D image of the breasts.
Minimally invasive breast biopsy	The use of a needle to extract a tissue sample from the breast to test for cancer cells.

Treating Paget's Disease of the Nipple

If you're diagnosed with Paget's disease of the nipple, treatment will depend on your general health and the results of your tests.

Your doctors and other specialists at the Magee-Womens Breast Cancer Program will work with you to consider your options and determine a course of action.

Treatment options

Surgery is often the primary treatment for breast cancer.

In many cases, we may also recommend additional therapies before (neo adjuvant) or after (adjuvant) surgery to control an aggressive cancer or to reduce the risk of recurrence.

Procedures and treatments for breast cancer may include:

Surgical Procedures
Mastectomy	The surgical removal of part of the breast with a cancerous tumor (lumpectomy), breast tissue, or the entire breast. In some cases, lymph nodes are also removed. In rare cases, some of the chest muscles are removed as well.
Sentinel lymph node biopsy	A minimally invasive procedure to remove lymph node tissue in the armpit to check if existing breast cancer is spreading (metastasizing). Women diagnosed with an invasive breast cancer typically undergo a sentinel lymph node biopsy.
Axillary lymph node dissection	Surgery to remove all or a group of lymph nodes in the underarm (axilla), if your sentinel lymph node biopsy is positive for cancer.
Additional Breast Cancer Therapies
Chemotherapy	The administration of drugs to destroy the growth abilities of cancer cells. It is sometimes used with radiation therapy.
Radiation therapy	The use of beams of high-energy waves of ion particles to destroy the growth abilities of cancer cells. External radiation therapy directs rays at the tumor from outside a person's body.
Hormone therapy	The use of drugs that stop the production of certain hormones that the cancer needs to grow.