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Paget’s Disease of the Nipple  

A fairly rare form of breast cancer is called Paget’s disease of the nipple.  It is a condition in which cancer cells form in and around the nipple.  This type of cancer is thought to account for about 5% of all breast cancer cases in the US.  But it is important to know about the symptoms of the type of breast cancer because most of the people who have it also have another type of breast cancer can be either in situ or invasive.  But let’s discuss some further details here. 

This type of cancer usually originates in the ducts of the nipple and then spreads to the nipple surface itself and the areola.  When this happens, the nipple and areola can become red, itchy and irritated. 

It is not known exactly why this form of breast cancer develops.  One theory is that the cancer begins growing inside of the milk ducts within the breast and is then carried out to the nipple itself.  This can help explain why the vast majority of people who have this type of cancer also have another type of cancer within the breast itself. 

This disease affects the vast majority of women.  However to a much lesser extent, men can be affected as well.  It normally develops after the age of 50 and the average age where the cancer was diagnosed in women was 62 and in men age 69. 

The common symptoms of this type of breast cancer are changes to the color and texture of the skin in and around the nipple.  It may appear to be red, sore or flaky.  Initially these symptoms can come and go. 

Other symptoms to look for include itching and burning sensation in the nipples; pain and sensitivity to touch; thickening of the skin in and around the nipples; a flattening of the nipples; and a yellowish or bloody discharge from the nipples. 

It is unfortunate but because this type of breast cancer is so rare, it can be mistaken for other problems.  Doctors may mistake it for an infection, injury or a rash.  In some cases it may take several months of visits to get an accurate diagnosis.  If you experience these symptoms it is usually best to see a breast specialist who is more experienced in diagnosing the problem correctly. 

In order to properly diagnose Page’s disease of the nipple, a number of steps are performed.  This first involves a physical examination of the breasts with special attention paid to the nipple area.  The doctor will be checking for unusual masses or lumps within the breast as well. 

A mammogram would also be done to check for evidence of cancer in the breast and nipples.  Ultrasound or breast MRI’s may be included to check further details.  And finally a biopsy of the nipple and areola is usually performed to take a sample of tissue in the affected area for further study.  If there is an unusual discharge from the nipple, a sample of that material will be taken as well. 

Once a positive diagnosis is confirmed, the most common type of treatment is surgery to remove the cancerous tissue.  The type and degree of surgery depends on the severity of the cancer and whether it is also present in other parts of the breast.  Surgeons try to limit the amount of breast tissue removed in order to help conserve the breast.  So the nipple and areola may be removed as well as a lumpectomy if the cancer is also present somewhere in the breast itself.  If the condition is more widespread than a mastectomy may be the best course of action. 

Additional treatments including chemotherapy, radiations therapy or hormone therapy may be performed to help to assure that all the cancer has been removed or destroyed.  Follow up treatment and care if very important to watch for any complications or return of the disease.