Redness, itching, scaling or crusting of the nipple can be mistaken for a harmless skin condition. However, when these symptoms persist or worsen over time, they may point towards Paget’s disease of the breast, a rare type of breast cancer that affects your nipple and areola. Since the symptoms of this condition can closely resemble eczema, many patients do not seek medical attention until the condition has progressed. Early diagnosis and timely treatment can help improve results and provide appropriate cancer care. At the CK Birla Hospital, our breast specialists provide personalised evaluation and treatment for Paget’s disease of the breast, supported by advanced imaging, accurate diagnosis, and multidisciplinary cancer care.
Paget’s disease of the breast is an uncommon breast cancer that majorly affects the skin of the nipple and areola. It is associated with cancer cells present within the breast tissue, either in the milk ducts or the surrounding breast tissue. These cancer cells migrate through the milk ducts and reach the nipple, causing visible skin changes. Because the condition presents with itching, redness and scaling of the breast skin, it can be mistaken for dermatitis or eczema. This can lead to delays in diagnosis and treatment.
Paget’s disease can affect both men and women; however, it is more commonly seen in women over the age of 50.
Paget’s disease of the breast may be grouped into different types depending on whether an underlying breast cancer is present.
In this type, abnormal cancer cells are confined to the milk ducts and have not spread into surrounding breast tissue.
Some patients have an invasive tumor beneath the nipple or elsewhere in the breast. In these cases, cancer cells have spread beyond the ducts into nearby breast tissue.
It affects the nipple without a detectable underlying tumor.
Imaging tests and a biopsy help confirm the diagnosis and determine the most appropriate treatment plan.
The exact cause of Paget’s disease of the breast is still being studied. However, current evidence suggests that the condition develops when cancer cells from an underlying breast tumour travel through the milk ducts to the nipple.
Factors may increase the risk:
Risk factors can increase the chances of developing the condition, but they are not a diagnosis. If you notice unusual or frequent changes in your nipple or breast, schedule a consultation with a breast specialist for further evaluation.
Being aware of Paget’s breast disease symptoms can help patients seek medical attention at an earlier stage.
Some common symptoms of this condition are:
Many patients initially mistake Paget’s disease nipple changes for eczema because the symptoms can look very similar. However, when symptoms affect only one nipple and do not improve with routine skin treatments, further evaluation is recommended
Before deciding on the most appropriate treatment, doctors need to understand how far the disease has progressed and whether there is an underlying breast tumour. They also consider the stage of the cancer and your overall health. To evaluate these factors, they may recommend the following diagnostic tests:
Once the diagnosis is confirmed, your treatment plan is personalised based on your test results, the extent of the disease, and your overall health. Depending on these findings, treatment may include:
It may be an option if the disease is limited to a small area of the breast. During the procedure, the surgeon removes the nipple, areola and the affected breast tissue while preserving as much healthy breast tissue as possible. Radiation therapy is usually recommended after surgery to reduce the risk of recurrence.
Mastectomy: If there is extensive disease or a larger underlying tumor, removal of the entire breast is done. Depending on your medical condition and personal preferences, your doctor may also discuss breast reconstruction as part of your treatment plan.
Sentinel Lymph Node Biopsy: This procedure may be performed to check whether cancer has spread to nearby lymph nodes. The results help find out the stage of the cancer and guide further treatment decisions.
Radiation Therapy: It uses high-energy rays to target and destroy remaining cancer cells after surgery. It is usually recommended to reduce the likelihood of the cancer returning.
Depending on the pathology results, additional treatments may include:
Recovery varies based on the type of surgery and additional treatments received
Patients are generally advised to:
Most patients gradually return to normal activities over the following weeks.
Regular monitoring remains an important part of long-term breast health after treatment.
We, at the CK Birla Hospital, bring together specialists across breast surgery, oncology, radiology, pathology, and reconstructive surgery to provide coordinated care for patients with Paget’s disease of the breast. Our strengths include:
If you are experiencing symptoms suggestive of Paget’s disease of the breast, schedule a consultation with our breast specialists at the CK Birla Hospital.
The earliest signs of this condition are redness, itching, flaking, crusting, or irritation of the nipple. Some patients may also notice a burning sensation or nipple discharge.
Eczema usually affects both breasts or areas beyond the nipple and responds to skin treatments. Paget’s disease affects one nipple, persists despite treatment, and may be associated with underlying breast cancer. A relevant diagnostic test suggested by a breast specialist is required for confirmation.
Treatment usually involves surgery, which may be breast conserving surgery or mastectomy. Depending on the diagnosis, radiation therapy, chemotherapy, hormone therapy, or targeted therapy may also be recommended.
Diagnosis generally includes a clinical examination, breast imaging such as mammography or MRI and a biopsy of the affected nipple or breast tissue. These tests help confirm the diagnosis and determine the extent of disease.
