Paget's disease of the breast: what does it consist of?

Breast Paget's disease is also known as Paget's disease of the nipple or Paget's disease of the breast. It is a rare form of cancer that affects the skin of the nipple and areola; that is to say, to the dark skinned circle around it.

Most commonly, people with Paget's disease of the breast also have tumors inside the breast. Between 1 and 4% of breast cancer cases also include Paget's disease of the breast.

This type of cancer affects both men and women, but it is more common in the latter. The average diagnosis is made in 57-year-olds. However, Paget's disease of the breast can present in adolescence and also in old age.

Possible causes of Paget's disease of the breast

Paget's disease of the breast is a type of cancer that affects the nipple and areola.

Science still doesn't fully understand the reasons for Paget's disease of the breast. In this regard, there are two basic hypotheses. The first and most widely accepted indicates that cancer cells travel from the internal tumor in the breast to the nipple and the areola.

From that point of view, such cells travel through the milk ducts. This would be the reason why it is so frequent that this disease coincides with the presence of tumors within the breast.

Another hypothesis indicates that the cells in the nipple and areola become cancerous on their own., regardless of the tumors that may be within the breast. This would explain why in some cases Paget's disease of the breast occurs without tumors in the breast.


The most visible symptom of Paget's disease of the breast is irritation of the skin on the nipple and areola., the area around it. In many cases, this is mistaken for dermatitis or a skin condition and is not associated with cancer.

Other common symptoms of Paget disease of the breast according to data published by the National Cancer Institute (NIH) include the following:

  • Scaly skin over the nipple.
  • Brittle or hardened skin on the nipple and / or areola.
  • Redness of the area and itching.
  • Burning or tingling in the area.
  • Nipple flattened or turned inward.
  • There may be a discharge yellowish or bloody.
  • Thickening of the skin of the chest.
  • Presence of a lump in the area.

The most common is that the symptoms appear only in one of the breasts. Also, the common thing is that it starts at the nipple and spreads from there. If the skin is treated, there may be temporary improvement, but then symptoms return.

Diagnosis of Paget's disease of the breast

In many cases, Paget's disease of the breast is initially diagnosed as eczema. based on a physical examination and a clinical interview with the patient. Sometimes it takes many months before the actual diagnosis is obtained.

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The appearance of the injury is that of a reddish plaque that flakes and has ragged edges. The size varies between 3 and 15 centimeters. It is located on the nipple or very close to it, on the areola.

If the healthcare provider is suspicious, they usually order an ultrasound, a mammogram, or an MRI. However, the definitive diagnosis is usually established from a biopsy, as explained by the University of Navarra Clinic.

Treatment options

Treatment of Paget's disease of the breast usually involves surgery.

If a person has Paget's disease of the breast, you will most likely need to have surgery. There are several types of surgical interventions for these cases. A specific modality will be chosen according to the condition of the skin and the progress of the cancer. Treatment options include either type of surgery and adjuvant therapy. Let's see.

Simple mastectomy

In this procedure, the entire breast is removed, but the lymph nodes in the armpit are not touched. This surgical procedure is recommended when breast cancer is present but has not spread to the lymph nodes.


In this case, only the diseased area of ​​the breast is removed. The nipple and areola, along with diseased breast tissue, are removed, leaving an outer margin free of cancer cells. After surgery, follow-up radiation therapy should be done. The nipple can be reconstructed with another surgical procedure.

Adjuvant therapy

Typically, after the operation, the doctor order some type of cancer treatment. It can be chemotherapy, radiation therapy, or hormone therapy. The goal is to prevent the disease from returning.

Faced with the diagnosis, seek professional support

Cancer diagnosis is shocking for anyone. For the same, it is important to have information and support to cope with the disease and treatment. A person in these conditions requires a supportive social network and, on some occasions, a professional counselor.

It is important to take maximum care of yourself while the treatment is carried out. This means getting a good night's sleep, proper nutrition, regular physical activity, and spending time for recreation and relaxation.