Paget’s Disease of the Breast is a rare form of breast cancer that affects the skin and underlying tissue of the nipple and areola. Named after Sir James Paget, the English surgeon who first described the condition in 1874, it is estimated to account for approximately 1-4% of all breast cancers. While it primarily affects women, men can also develop Paget’s Disease of the Breast, albeit very rarely.
The exact cause of Paget’s Disease of the Breast is still uncertain, but it is believed to be associated with an underlying breast cancer. In most cases, there is an associated ductal carcinoma in situ (DCIS) or invasive breast cancer elsewhere in the breast. The cancer cells from these underlying sources migrate to the skin of the nipple and areola, resulting in the characteristic skin changes and symptoms associated with Paget’s Disease.
Symptoms of Paget’s Disease of the Breast typically include persistent itching, redness, crusting, or scaling of the nipple and areola. These changes may initially be mistaken for other skin conditions such as eczema or dermatitis. As the disease progresses, the nipple may become inverted and discharge may be present. It is important to note that not all cases of Paget’s Disease present with a visible lump in the breast, which can lead to delayed diagnosis.
To diagnose Paget’s Disease of the Breast, a combination of clinical examination, imaging studies, and biopsy is usually performed. A mammogram is commonly arranged to evaluate the underlying breast tissue, and an ultrasound may also be used to provide further imaging information. However, the definitive diagnosis is made performing a biopsy of the affected skin. This involves taking a small sample of the skin tissue and examining it under a microscope to look for cancerous cells.
Once a diagnosis of Paget’s Disease of the Breast is confirmed, further staging tests are usually conducted to determine the extent of the disease and if it has spread to other areas of the body. This may involve additional imaging studies such as a CT scan or an MRI. The stage of the disease plays a crucial role in determining the appropriate treatment approach.
The treatment for Paget’s Disease of the Breast usually involves a combination of surgery, radiation therapy, and sometimes systemic treatments like chemotherapy or hormonal therapy. The primary goal of treatment is to eliminate the cancer cells from the affected area while preserving the appearance of the breast. In cases where the underlying breast tissue is involved, a mastectomy (complete removal of the breast) may be required. However, breast-conserving surgeries such as lumpectomies may be possible for select cases. After surgery, radiation therapy is typically administered to reduce the risk of local recurrence. Systemic treatments may be recommended if there is evidence of underlying breast cancer or if the disease has spread.
The prognosis for Paget’s Disease of the Breast varies depending on several factors, including the stage of the disease, the presence of underlying breast cancer, and the response to treatment. Generally, early detection and treatment provide a more favorable outcome. However, due to the rarity and unique characteristics of Paget’s Disease, the long-term survival rates are not well-defined.
Paget’s Disease of the Breast is a rare form of breast cancer that affects the nipple and areola. It is typically associated with an underlying breast cancer and presents with unique symptoms such as nipple itching, redness, and crusting. Diagnosis involves clinical examination, imaging studies, and a biopsy of the affected skin. Treatment options include surgery, radiation therapy, and systemic treatments. Early detection and treatment are crucial for improved outcomes. If you notice any persistent changes in your nipple or areola, it is important to seek medical attention for further evaluation and diagnosis.