Overview
Paget's disease of the breast is a rare form of breast cancer that starts on the nipple and extends to the dark circle of skin (areola) around the nipple. It is not related to Paget's disease of the bone, a metabolic bone disease. Paget's disease of the breast usually occurs after the age of 50 and is often associated with underlying ductal breast cancer. The disease typically affects the nipple and may spread to the areola and other areas of the breast. Symptoms may include flaky or scaly skin on the nipple and can be mistaken for skin irritation or other noncancerous skin conditions. It's important to be aware of any changes in your breasts and consult your doctor if you experience a lump or persistent skin irritation.
Understanding the disease
Symptoms
The symptoms of Paget's disease of the breast are flaky or scaly skin on the nipple, crusty, oozing or hardened skin resembling eczema on the nipple or areola, itching, redness, a tingling or burning sensation, straw-colored or bloody nipple discharge, a flattened or turned-in (inverted) nipple, and a lump in the breast.
Risk Factors
Risk factors for developing Paget's disease of the breast include factors that affect your likelihood of developing any other type of breast cancer. These risk factors include:
- Increasing age: Your risk of breast cancer increases as you age.
- Personal history of breast conditions: If you've had a breast biopsy that found lobular carcinoma in situ (LCIS) or atypical hyperplasia of the breast, you have an increased risk of breast cancer.
- Personal history of breast cancer: If you've had breast cancer in one breast, you have an increased risk of developing cancer in the other breast.
- Family history of breast cancer: If your parent, sibling, or child was diagnosed with breast cancer, particularly at a young age, your risk of breast cancer is increased.
Development
Paget's disease of the breast typically starts in the nipple and may spread to the areola and other areas of the breast. It is believed to result from underlying ductal breast cancer, where cancer cells travel through milk ducts to the nipple and its surrounding skin. In rare cases, the disease may develop independently in the nipple. Fibrocystic breasts, on the other hand, refer to the presence of tissue with a lumpy or ropelike texture in the breasts, which can be normal and fluctuate with the menstrual cycle. Fibrocystic breast changes do not constitute a disease, and breast symptoms associated with them can often be relieved through self-care measures.
Assessment and Diagnosis
Triage
If you suspect Paget's disease of the breast, you should see a doctor if you experience any of the following symptoms:
- Flaky or scaly skin on your nipple
- Itching or skin irritation that persists for more than a month
- A lump in your breast If you notice any changes in your breasts or experience persistent symptoms, it's important to make an appointment with your doctor. Early detection and diagnosis are crucial for effective treatment and management of Paget's disease of the breast.
Diagnosis
The diagnostic tests and procedures for Paget's disease of the breast, include a breast exam, mammogram, breast ultrasound, breast magnetic resonance imaging (MRI), and a biopsy. The doctor may use these methods to determine the presence of abnormalities, assess the extent of the disease, and determine the appropriate treatment plan.
Management and Treatment
Home Remedies
regarding home remedies for Paget's disease of the breast. It is essential to consult with a healthcare professional, such as a doctor, for proper diagnosis and treatment options.
Treatment
Treatment for Paget's disease of the breast typically involves surgery, as the condition often signifies an underlying breast cancer. The type of surgery performed depends on the condition of the skin around the nipple and the extent of the cancer. Surgical options may include breast-conserving surgery, lumpectomy, or mastectomy. In addition to surgery, other treatment options for Paget's disease of the breast may be considered based on individual circumstances. These may include radiation therapy, chemotherapy, hormone therapy, or targeted therapy. It's crucial to consult with a healthcare professional experienced in treating breast conditions to determine the most appropriate treatment plan for each individual case.
Preparing for medical consultation
To prepare for an appointment for Paget's disease of the breast, you should:
- Be aware of any pre-appointment restrictions and inquire about them when you schedule the appointment.
- List all your symptoms, even those that may seem unrelated to the reason for the appointment.
- Provide key personal information, including any major stresses or recent life changes.
- Make a list of all medications, vitamins, or supplements you are currently taking. Remember to also write down any questions you have for your healthcare provider, prioritizing them in case time is limited. Some basic questions to ask include:
- What's causing my symptoms?
- How is Paget's disease of the breast diagnosed?
- What treatments are available for Paget's disease of the breast?
- What is the likelihood of the disease progressing or recurring?
- What lifestyle changes or precautions should I take to manage the condition?
- Are there any clinical trials or new treatments available for Paget's disease of the breast?