Paget's disease of the breast

Paget's disease of the breast, also known as Paget's disease of the nipple, is a condition that outwardly may have the appearance of eczema - with skin changes involving the nipple of the breast. Because of its seemingly innocuous and surface appearance, it often presents late, but it is a condition that may be fatal.

Extramammary Paget's disease (EMPD) has the same histologic features as Paget's disease of the breast but different locations.

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Symptoms

Usually only affecting one nipple, The first symptom is usually an eczema-like rash. The skin of the nipple and areola may be red and inflamed. Some women have an itching or burning sensation. Fluid (discharge) may leak from the abnormal area of cells. The nipple may turn inwards (be inverted). There may or may not be a lump in the breast there may be redness, oozing and crusting, and a sore that does not heal.

Diagnosis

Recommended tests are a mammogram and a biopsy to confirm the diagnosis, and cytology may also be helpful.

Treatment

Treatment usually involves some kind of mastectomy to surgically remove the tumour. Chemotherapy and/or radiotherapy may be necessary.

History

The condition is named after Sir James Paget, an English surgeon who first described it in 1874.