8 Important Facts About Paget’s Disease of the Breast
Paget’s disease of the breast is a rare type of cancer that primarily affects the nipple and, occasionally, the areola. It manifests as eczema-like changes such as redness, scaling, and irritation on the nipple and surrounding skin. Often, this disease is associated with an underlying ductal carcinoma in situ (DCIS) or invasive breast cancer, which might not always present with a palpable lump.
1. What is Paget’s disease of the breast?
Paget disease of the breast is a very uncommon breast cancer that impacts the skin of the areola and the nipple, the circle of darker skin around the nipple. In this disease, the cancerous cells named Paget cells are present in the surface layer of the nipple and the areola skin.
Many people with Paget disease of the breast diagnosis have one or more tumours in the same breast. Approximately 1-4% of all breast cancer cases also involve Paget disease of the breast.
2. What are the other names of Paget’s disease?
The other names are Paget disease of the breast, Paget’s disease, Paget disease of the nipple, and mammary Paget disease.
3. What causes Paget’s disease?
Paget’s disease of the breast is challenging for doctors to understand fully. The common theory is that cancer cells from a tumour inside the breast reach the nipple and areola through the milk ducts. This would clarify the frequent coexistence of Paget disease of the breast and tumours within the same breast.
A second theory states that cells in the nipple or areola change cancerous by themselves, which explains why some people develop Paget disease of the breast without having a breast tumour inside. Paget disease of the breast and tumours within the same breast may develop independently.
4. What are the risk factors of Paget disease of the breast?
The risk factors are:
- Obesity
- Increasing age
- Benign breast disease history
- A family history of breast cancer
- History of breast cancer
- Having dense breast tissue
- Radiation exposure
- Caucasian women have a higher chance of breast cancer
- Using a combination of estrogen-progestin hormone replacement therapy after menopause
5. What are the symptoms of Paget’s disease of the breast?
Paget’s breast disease can have symptoms that closely resemble benign skin conditions. The symptoms are as follows:
- Redness
- Breast lump
- A flattened nipple
- Itching or tingling of the nipple or areola.
- Nipple discharge that may be yellowish or bloody.
- Flaking, crusty, or thickened skin on or around the nipple.
6. How to diagnose Paget’s disease of the nipple?
The Paget’s disease diagnosis tests are:
- Breast exam
- Biopsy
- Mammography
- Ultrasound scan
- MRI
- Sentinel lymph node biopsy
7. What is Paget disease in breast treatment?
Cancer treatment is based on the cancer’s severity and other factors.
Surgery and sometimes other cancer treatments are part of the treatment.
- Surgery –
- Mastectomy
- Breast-conserving surgery
Other breast cancer treatments include:
- Chemotherapy
- Radiotherapy
- Targeted therapy
- Hormone therapy
8. Which doctor treats Paget’s disease of the breast?
Paget’s disease of the breast is typically treated by a multidisciplinary team, including a breast surgeon, medical oncologist, radiologist, dermatologist, and potentially a radiation oncologist, depending on the specific needs and treatment plan of the patient.
