Paget's Disease of the Nipple

Symptoms of Paget's Disease of the Nipple

Early symptoms of Paget's disease of the nipple include:
  • Redness around the nipple
  • Mild scaling of the nipple skin
  • Flaking of the nipple skin.
These early symptoms may cause only mild irritation and may not be enough to prompt a visit to the doctor. Improvement in the skin can occur spontaneously, but this should not be taken as a sign that the disease has disappeared.
More advanced symptoms may show more serious destruction of the skin. At this stage, the symptoms of Paget's disease of the nipple may include:
  • Tingling
  • Itching
  • Increased sensitivity
  • Burning
  • Pain
  • Discharge from the nipple.
The nipple may also appear flattened against the breast.
In approximately half of the people with Paget's disease of the nipple, a lump or mass in the breast can be felt during physical examination. In most cases, the disease is initially confined to the nipple, later spreading to the areola or other regions of the breast. The areola is the circular area of darker skin that surrounds the nipple. Paget's disease of the nipple can also be found only on the areola, where it may resemble eczema, a non-cancerous, itchy, red rash. Although rare, Paget's disease can occur in both breasts.

How Is It Diagnosed?

If a healthcare provider suspects Paget's disease of the nipple, a biopsy of the nipple skin is performed. In a biopsy, the doctor removes a small sample of tissue. A pathologist (someone who studies disease) examines the tissue under a microscope to see if Paget cells are present. The pathologist may use a technique called immunohistochemistry (staining tissues to identify specific cells) to differentiate Paget cells from other cell types. A sample of nipple discharge may also be examined under a microscope for the presence of Paget cells.
Because most people with Paget's disease of the nipple also have underlying breast cancer, physical examination and mammography (x-ray of the breast) are used to make a complete diagnosis.
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