What is Paget's disease of the breast?

Paget's disease of the breast is a rare type of breast cancer that starts in the skin of your nipple and sometimes in the darker skin around it. Sometimes, it is an early form of breast cancer that stays in the nipple, but more often, there is also a more serious cancer in the milk ducts of the same breast. It's also called mammary Paget's disease.

Paget's disease of the breast looks like eczema on your nipple and may seem like an ordinary rash at first. The symptoms may be itchiness and scaliness, red or elevated plaques on your skin, and discharge from the nipple. Most people who have such symptoms don't have Paget's disease. If you do have it, these could be the first noticeable signs of already existing cancer in the breast.

Who gets Paget's disease of the breast?

Paget's disease of the breast occurs almost exclusively in people who were assigned female at birth, though there have been rare cases in people assigned male at birth. It can happen in anyone between any age bracket; the average diagnosis age is 57, though it has also been documented in people younger and older. Less than 4% of breast cancer cases include Paget's disease of the breast.

How aggressive or fast does Paget's disease of the breast grow?

The answer depends on whether you have underlying ductal carcinoma and what stage it is in. If cancer is confined to the milk ducts and has not spread to nearby breast tissue, it is known as "ductal carcinoma in situ" (DCIS), classified as stage 0. This type of cancer is typically treated with the surgical removal of the tumor(s) and sometimes the nipple, followed by radiation therapy.

Ductal carcinoma can spread out from the milk ducts. This is called invasive ductal carcinoma. It can move forward in stages, with some parts treatable while others remain. Removing the affected breast tissue and the lymph nodes in the armpits can still help, but if left untreated, the cancer can get worse quickly as it moves to later stages.

What are the signs and symptoms of Paget's disease of the breast?

Symptoms affect your nipple and/or areola. They often appear on only one side, but in some rare cases, they occur on both. They may develop and disappear temporarily but worsen over time. Some symptoms of this disease are:

• An itchy nipple that, at times, becomes burning.
• Nipple or areola dry skin, flaking, or scaly.
• The rash of skin that is either red, raised, crusting, raw, or even bleeding.
• Swelling and redness.
• The crusting, oozing, which almost resembles weeping eczema.
• Bloody or pus-like nipple discharge.
• Flat or inverted nipple.
• The presence of palpable breast lumps under the skin.

What causes Paget's disease of the breast?

Scientists are still mystified by what causes cancer in general, but ongoing research continues to turn up new clues. Cancer starts when certain cells in the body change abnormally. These cells divide and replicate uncontrollably. Current research suggests these changes may begin in your DNA. However, we still don't know why they happen.

Scientists have found that certain "risk factors" may be linked to cancer. For example, you may have a higher chance of getting cancer if you are exposed to specific environmental toxins or if you smoke or drink alcohol excessively. It is essential to understand that 85% of breast cancer cases arise in individuals with no identifiable risk factors.

How is Paget's disease of the breast diagnosed?

Your doctor may first try to treat your condition as eczema. If that does not work, or if they think you might have Paget's disease of the breast, they will take a small sample of tissue from your nipple to look at under a microscope. Paget's cells are easy to see this way. They will use a tool shaped like a small circle, similar to a hole punch, to take a tiny round piece.

Once your doctor knows you have Paget's disease of the breast, they need to check if there is also ductal carcinoma and how far it has gone. They do this with imaging tests like a mammogram or breast ultrasound. If they find an area that looks suspicious, the doctor will use a needle to take a sample of the breast tissue.

How is Paget's Disease of the Breast Treated?

Treatment for Paget's disease of the breast typically involves surgery, and in some cases, additional cancer therapies.

Breast Cancer Surgery

If you have cancer in your breast, you will need surgery to remove it. How much tissue is taken out depends on your specific situation. If you only have Paget's disease and no other tumors, you might have a less extensive surgery. This type of surgery aims to keep as much healthy tissue as possible. In this case, the surgeon will remove the nipple, areola, and a small margin of surrounding healthy tissue.

However, if the cancer is more extensive, the surgeon may recommend a mastectomy, where a more significant portion of breast tissue is removed. If desired, breast reconstruction surgery can be performed later.

Adjuvant therapy

You will most likely receive other complementary treatments after surgery to prevent cancer from coming back. Adjuvant therapies may include the following:

• Radiation therapy.
• Chemotherapy.
• Hormone therapy.
• Immunotherapy.

Can Paget's disease of the breast be cured?

The survival rate of breast cancer is merely based on the stage at the time the disease is diagnosed. If you are only diagnosed with Paget's disease of the nipple or ductal carcinoma in situ (stage 0) and you are diagnosed before it spreads beyond the milk ducts, the prognosis is excellent. Most people who discover and treat these conditions in time will be cured completely. When breast cancer starts to spread, it becomes increasingly difficult to win.

When should I see my healthcare provider about Paget's disease of the breast?

See your healthcare provider anytime you experience changes in your breasts, skin condition, or what appears under your skin. Usually, it's not cancer; you want to check on it. For example, when there are eczema-like conditions on your nipple or areola, and after treatments, you notice that nothing has improved, visit your healthcare provider for further evaluation tests.

Why choose Tender Palm Super-Speciality Hospital for Paget’s Disease of the Breast treatment in Lucknow, India?

Tender Palm Super-Speciality Hospital offers advanced Paget’s Disease of the Breast treatment in Lucknow, India, at an affordable cost. We have a team of experienced oncologists and breast cancer specialists, known as some of the best doctors for rare breast conditions. We provide accurate diagnosis with advanced imaging and biopsy tests, personalized treatment including surgery and additional therapies when required, and comprehensive supportive care. Our team has decades of experience in successfully treating Paget’s Disease of the Breast in Lucknow, India.

To seek an Expert Consultation for Paget’s Disease of the Breast treatment in Lucknow, India:

Call us at +91-9076972161
Email at care@tenderpalm.com

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