Paget’s disease of the nipple
Paget's disease of the nipple, also known asPaget's disease of the breast, is a rare condition associated with breast cancer .
It causes eczema-like changes to the skin of the nipple and the area of darker skin surrounding the nipple (areola). It's usually a sign of Breast cancer in the tissue behind the nipple. About 1-4% of women with breast cancer have Paget's disease of the nipple.
The term Paget's disease of the nipple is used to distinguish the condition from Paget's disease of the bone (where bones become weak and deformed).
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Paget's disease of the nipple always starts in the nipple and may extend to the areola. Itappears as a red, scalyrash on the skin of thenipple and areola.
The affected skin is often sore and inflamed, and it can be itchy or cause a burning sensation. The nipple can sometimes be ulcerated.
The rash is often similar in appearance to other skin conditions, such as eczema or psoriasis . If you scratch it, or if it's left untreated, it can bleed, become ulcerated or scab over.
If you're experiencing itchiness, burning or bleeding but the nipple looks normal and isn't red or scaly, it isn't Paget's diseaseof the nipple. However, you should still have it checked by a doctor.
Around half of all women diagnosed with Paget's disease of the nipple have alump behind the nipple. In 9 out of 10 cases this is an invasive breast cancer.
Invasive cancer is where cancerous cells invade the surrounding breast tissue.Some women with Paget's disease have invasive breast cancer but don't have a lump.
However, most women with Paget's disease who don't have a lump have non-invasive cancer. This is where the cancerous cells are contained in one or more areas of the breast and have not spread.
Thecause of Paget's disease of the nipple is unknown. Some women appear to be more at risk of developing breast cancer, but not specifically Paget's disease. There are no known causes that lead to a specific type of breast cancer.
In terms of risk factors, you're more likely to developbreast cancer if you:
Although most breast lumps aren't cancerous, it's important to have them checked out.
A biopsy is used to confirm a suspected diagnosis of Paget's disease of the nipple.A small tissue sample (punch biopsy of the skin) will be taken from your nipple and examined under a microscope to see if it's cancerous.
If the results of the biopsy indicate Paget's disease, you'll have a mammogram (a low-dose breast X-ray ) to investigate further.
Depending on whether the cancer has spread, surgery will either involve removing the whole breast (a mastectomy ), or the nipple and areola with the breast tissue underneath them(a central excision).
If the whole of your breast is removed, breast reconstruction surgery can be used to create a breast shape to match your remaining breast.
You may also need further treatment if you have invasive breast cancer. This may be a combination of:
If Paget's disease is detected and treated in its early stages, there's a good chance of a full recovery.
In the UK, the NHS Breast Screening Programme provides free breast screening every three years for all women aged 50-70.
In some areas, women aged 47-49 and 71-73 are also invited for screening as part of a study looking at whether the age range for breast screening should be extended.
Find out about Pagets disease of the nipple (Pagets disease of the breast). It's a rare condition where eczema-like changes occur in the the skin of the nipple and areola.
Find out how Pagets disease of the nipple is diagnosed. Your GP will examine your breasts and ask about your symptoms. They may refer you to a breast clinic for further tests.
Find out how Pagets disease of the nipple is treated. Surgery is usually used, which may involve a mastectomy (removal of the breast) or breast-conserving surgery.