by A.L.Smith

Created on: May 22, 2010

Paget's disease of the nipple, also know as Paget's of the breast, is a rare form of breast cancer. Traditionally the disease affects women over the age of 50, however Paget's of the nipple can sometimes occur in women as young as 20. Paget's disease of the nipple only accounts for less then 5% of all breast cancers.

The early symptoms of Paget's of the nipple can often be mistaken, by sufferers, as eczema. Sometimes the condition will appear to improve on it's own, or with some creams, but the improvement is short lived and should not be taken as a sign that the disease is getting better. With any noticeable change in the nipple, areola, or breast tissue consult your physician.

Symptoms of Paget's of the nipple include but are not limited to:

Persistent dry skin

Flaking and or scaling of the nipple skin

Itching and mild irritation

As the disease progresses, the symptoms worsen and may expand to include:

Increased itching

A burning sensation

Tingling

Pain

Weeping or discharge from the nipple

The nipple may become inverted or appear flattened

As the progression of the disease continues the affected area could spread to the areola, and beyond.

In most cases Paget's of the nipple is accompanied by an underlying cancer. An estimated 97% of cases also have an invasive breast cancer or Ductal Carcinoma in situ, also know as DCIS. In it's rarest form Paget's of the nipple has no underlying cancer. In the case of no other underlying cancer it is believed the skin cells of the breast spontaneously become Paget's cells.

Paget's disease of the nipple is diagnosed with a biopsy. If the biopsy is positive for Paget's cells other measures are taken to investigate the breast for an underlying cancer using mammography, breast MRI or ultrasound. If and when an underlying cancer is found and diagnosed a treatment plan begins.

The most common treatment for Paget's disease of the nipple is mastectomy, however, if there is no underlying invasive cancer, breast conserving surgery may be an option. Even with breast conserving surgery, such as lumpectomy, the entire nipple and areola will still be removed.

Treatment after surgery, know as adjuvant therapy, depends on the extent and type of surgery, the type and stage of the cancer, and of course the general health and well being of the patient.

Some forms of adjuvant treatment are:

Radiotherapy

Chemotherapy

Hormone therapy

Herceptin therapy

Combined adjuvant therapy, a combination of two or more of the above mentioned therapies.

Even when surgery is believed to have removed all of the cancer, adjuvant therapy may be used as a preventive measure.

Paget's disease of the nipple is not to be confused with skin cancer, it is a breast cancer and should be treated as such. As with any form of cancer, early detection is a key factor in treatment and recovery.

After a year of ignoring what I believed to be eczema on my breast, I consulted my family doctor. At age 36 I was diagnosed with Paget's of the nipple with underlying DCIS. In the span of a few short months I underwent testing, treatment and finally a mastectomy. Every women needs to understand that her body is like no one else and neither is her breast. Be aware of any and all changes, and have a doctor investigate any concerns. No concern is too small if it can save your breast, or your life.

Sources:

National Cancer Institute

The Intelligent Patient Guide to Breast Cancer. 4th Edition

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