Paget’s Disease of the Breast

What is Paget’s Disease of the Breast?

General description/overview

Paget’s disease of the breast is an uncommon type of breast cancer that appears on the nipple and the areola. Cancerous tumors are usually found within the milk ducts of the same breast. It is rare occurrence when it only affects the nipple.

When viewed under a microscope it is characterized by big circular malignant cells (Paget cells). They are found either individually or amassed in the uppermost layers of skin. It can occur in males as well as females, but it mainly strikes middle-aged women. The cause is unclear, but most doctors theorize that cancerous cells move via the milk ducts to outer areas of the breast, but not in every case. It may only appear on the nipple and areola.

What are the Symptoms of Paget’s Disease of the Breast?

Paget’s disease of the breast is often initially misdiagnosed. It can look like a simple case of dry skin, eczema, dermatitis or another harmless condition. A nipple biopsy is required for diagnosis. Signs and symptoms to be aware of include:

  • Scaling flaking skin on the nipple
  • Hardening of the nipple
  • Thickened skin on the nipple, areola or breast
  • Yellowish or bloody liquid oozing from the nipple and areola
  • Crusty buildup on or around the nipple
  • Itchiness
  • Redness
  • Burning or tingling skin
  • Inverted or flattened nipple
  • Breast lump(s)

Paget’s Disease of the Breast Causes

There is no known cause of Paget’s disease of the breast specifically, but it is known to be associated with breast cancer. Several risk factors for breast cancer have been identified.

A history of breast cancer, either in the same individual or in close relatives, increases the risk of developing breast cancer. A small percentage of women who have previously had non-cancerous breast disease are also at slightly higher risk of developing breast cancer. Age is also a risk factor, in that there is a higher risk in older people than in younger people.

Some lifestyle factors increase the risk of breast cancer. Being overweight is a primary risk factor, especially in women who have been through the menopause, because this increases the levels estrogen in the body. Alcohol also increases the risk of breast cancer – three in every 200 women who drink two glasses of alcohol per day will develop breast cancer.

How is Paget’s Disease of the Breast Treated?

The treatment of Paget’s disease of the breast depends on the stage of the cancer and the characteristics of the tumor(s). Treatment may include the removal of the cancerous portion of the breast (lumpectomy). If the breast cannot be saved but nearby lymph nodes are healthy, a simple mastectomy will be necessary.

Treatment may also include:

  • Radiation therapy
  • Chemotherapy
  • Hormone therapy

Paget’s Disease of the Breast Prevention

The steps you can take to prevent Paget’s disease of the breast are the same as the preventive steps against breast cancer, because of the association between the two conditions.

There are several lifestyle adjustments you can make to reduce your risk. If you are overweight, reducing your weight to healthy levels is one effective measure – particularly if you have been through the menopause. Reducing your intake of saturated fat is another preventive step, and reducing your alcohol intake to a low level or abstaining from consumption completely will also lower your chance of developing breast cancer.

Two drugs are also sometimes prescribed to women who have a high risk of developing breast cancer – tamoxifen and raloxifene. These drugs are thought to reduce the risk by around a third; however, they also produce unpleasant side effects.

Screening is also important in preventing breast cancer, as the disease can be detected before a lump is formed. This allows preventive steps to be taken early.