Ask the doctor


Breast Cancer - Paget's Disease

One of the rare types of Breast Cancer isPaget's disease does not clear up with
Paget's disease of the nipple, which canroutine treatment for eczema or infection and
appear as a rash on the nipple. The rash orusually only affects one nipple.A mammogram
other changes in the nipple can indicate ais the next step to check for cancer in the
cancer in the breast ducts, many timesactual breast. Sometimes any underlying
located under the nipple, which has thenabnormal breast mass will not be present on a
extended itself onto the surface of themammogram. A clean mammogram combined with
nipple.Sometimes this sign of breast canceran abnormal nipple finding requires further
indicates a small ductal carcinoma in situinvestigation.A biopsy of the nipple tissue
(DCIS), which is a very early breast cancerwill need to be performed. Usually this
that has not yet left the duct. Other times,consists of a "punch biopsy" that removes a
Paget's disease of the nipple may indicate ansmall amount of tissue to check for cancer.
invasive cancer somewhere else in the breast.If the mammogram indicates other areas of
In some cases, a woman who shows signs ofconcern within the breast, biopsies of those
Paget's disease of the nipple willareas should be performed.If Paget's disease
additionally have an abnormal mammogram oris caught early while it is still confined to
have lump in her breast.Before we move on Ithe nipple and underlying breast ducts, the
want to clarify that Paget's disease of thepatient typically has an excellent prognosis.
nipple is not the same as Paget's disease ofHowever, if Paget's disease of the nipple
the bone, which is a severe bone disease.is associated with an invasive breast cancer
Sir James Paget, a British surgeon andor if the cancer has spread out of the breast
physiologist, discovered both conditionsto other areas of the body (metastatic
which were first documented by him, but theydisease), the survival rate can be
are completely unrelated diseases. Paget'slower.Treatment of Paget's disease of the
disease of the nipple can also affect men,nipple involves surgery, radiation treatment
although it is rare.Paget's disease of theand Chemotherapy or drug therapy (such as
nipple is often first noticed when physicaltamoxifen). Like other types of breast
signs of the disease appear. Signs ofcancer, the location of the cancer will
Paget's disease usually only occur on onedetermine which type of surgery is done - a
nipple and can include persistent crustiness,lumpectomy or mastectomy. Radiation therapy
scaliness, or redness of the nipple, itchingusually follows a lumpectomy.A recent
or burning of the nipple and surroundingdevelopment in surgical treatment involves
areola and bleeding or oozing from the nippleremoving only the nipple and areola
and areola.Paget's disease can often be(sometimes followed by radiation therapy) in
confused with other skin conditions, such aspatients whose Paget's disease has no other
breast eczema. Breast Eczema is a highlyunderlying breast cancer, thus allowing the
treatable condition which can bewoman to keep her breast. Following
characterized by red, itchy patches ortreatment, an artificial nipple can be
weeping blisters around the nipple whichrecreated using skin grafts and tattooing.
reoccur, but clear up with proper treatment.



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