Paget's Disease of the Breast/Nipple

Symptoms


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Paget's Disease of the Breast/Nipple is an uncommon type of breast cancer in which cancer cells collect in the skin of the nipples and the areola. They cause an itchy, scaly area which is frequently misdiagnosed as fungal infection or eczema, especially in men.

Paget's disease of the nipple and/or breast is named after Sir James Paget who discovered that the cells on the nipple in this condition was made of large cancerous cells.

The cancer starts in the cells of the skin of the nipple and then gradually spreads to the areola.

Paget's disease of the breast is relatively uncommon. It occurs in less than 5% of all women with breast cancers. It is frequently seen in combination with an underlying cancer of the breast ducts like Invasive Ductal Breast Cancer or Invasive Lobular Breast Cancer.

Paget's disease can occur in both men and women. But is is more often misdiagnosed in men and passed off as dermatitis or eczema.

Paget's Disease with Underlying Ductal Breast Cancer
Paget's Disease with Underlying Ductal Breast Cancer


Age at which Paget's Disease Occurs:

Paget's Disease is rare in young women under the age of 30. It is most common after the age of 60 years in both men and women. The average age at diagnosis is 62 for women and 69 for men.

Paget's Disease of the Nipple/Breast
Paget's Disease of the Nipple/Breast

Symptoms of Paget's Disease of the Nipple:

  • Mild Itchy Rash: Early Symptoms include redness and mild scaling and flaking of the nipple skin, which most women do not think is severe enough to merit going to the doctor. In some cases, there may only be a mild irritation and itching, not even scaling or dryness.

  • Rash with a crusty, flaky, hardened skin: The commonest symptom of Paget's disease of the Nipple is a red, flaky and scaly rash which can spread from the nipple to the surrounding areola. As the disease progresses, there may be tingling, itching, increased sensitivity, burning, and pain over the rash. A thin discharge may be present from the rash, forming a crust as it dries.

  • Discharge: There may be a thin, yellowish, sticky discharge from the rash. Drying of the discharge can cause the formation of a crust in some areas.

  • Change in Sensation: Some women may have a burning or tingling sensation of the skin affected by the rash and sometimes even in the surrounding areas. Itching, burning and chronic irritation is common.

  • Flattening of Nipple: As more and more skin gets destroyed, there may be flattening of the nipple against the breast. In some cases, the nipple can get inverted.

  • Breast Lump: In some cases, a small lump may be felt under the nipple or areola. Like most other types of breast cancers, these are also non-tender and firm lumps.

  • Nipple Discharge: Some women may have a nipple discharge which may be yellowish, greenish or reddish. Reddish implies the presence of blood while greenish or yellowish may indicate the presence of infection.

  • Pain: Pain is very uncommon. But in the presence of infection of the lump, there may be some amount of pain.

  • Site: In most cases, only one nipple is affected. But sometimes, both the nipples may be affected.

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