Paget's disease of the nipple

Paget's Disease of the Nipple, also known as Paget's Disease of the Breast, is a rare type of cancer involving the skin of the nipple and, usually, the darker circle of skin around it, known as the areola. It is named after Sir James Paget, who first described the condition in 1874. Although it is often associated with breast cancer, Paget's disease of the nipple itself specifically affects the epidermis (outer layer of skin) of the nipple and areola.

Symptoms

The symptoms of Paget's disease of the nipple can vary but typically include:

• Itching, tingling, or redness in the nipple and/or areola
• Flaky, scaly, or thickened skin on or around the nipple
• A flattened nipple (nipple inversion)
• Yellow or bloody discharge from the nipple
• A lump in the breast (in some cases)

Causes

The exact cause of Paget's disease of the nipple is not fully understood. However, most patients with this condition also have one or more underlying breast cancers. It is believed that cancer cells from a tumor inside the breast travel through milk ducts to reach the nipple and areola, causing the characteristic changes.

Diagnosis

Diagnosis of Paget's disease of the nipple involves a combination of clinical examination, imaging tests (such as mammography and ultrasound), and biopsy. A biopsy, where a small sample of tissue is removed and examined under a microscope, is crucial for confirming the diagnosis.

Treatment

Treatment for Paget's disease of the nipple typically involves surgery to remove the affected tissue. This may include:

• Mastectomy, where the entire breast is removed
• Breast-conserving surgery, where only the affected area is removed

The choice of surgery depends on the extent of the disease and whether there is an underlying breast cancer. Additional treatments may include radiation therapy, chemotherapy, or hormone therapy, depending on the specific characteristics of the underlying breast cancer.

Prognosis

The prognosis for Paget's disease of the nipple largely depends on the presence and extent of any underlying breast cancer. Early detection and treatment are crucial for improving outcomes.

Epidemiology

Paget's disease of the nipple is rare, accounting for less than 5% of all breast cancer cases. It most commonly affects individuals over the age of 50.

See Also

• Breast Cancer
• Mastectomy
• Chemotherapy
• Radiation Therapy