Paget’s Disease of the Breast

Paget’s disease of the breast is a rare type of cancer that develops in the skin of your nipple, and sometimes the areola (the darker skin surrounding the nipple). It may be isolated to the nipple as stage 0 breast cancer (ductal carcinoma in situ), or it may be accompanied by invasive breast cancer in the milk ducts of the same breast. It’s also called mammary Paget’s disease.

Paget’s disease of the breast resembles eczema on your nipple and may be mistaken for an ordinary rash at first. It may cause itching and scaling, red or raised plaques on your skin and discharge from the nipple. Most people who have these symptoms don’t have Paget’s disease. However, if you do, these may be the first noticeable signs of underlying breast cancer.

Who gets Paget’s disease of the breast?

Paget’s disease of the breast almost exclusively affects individuals who were assigned female at birth, although rare cases have been reported in people assigned male at birth. The average age of diagnosis is 57, but it has been found in people much younger and older, too. Less than 4% of breast cancer cases involve Paget’s disease of the breast.

How quickly or aggressively does Paget’s disease of the breast progress?

That depends on whether or not you have underlying ductal carcinoma, and what stage it’s in. If you only have cancer in your milk ducts and it hasn’t spread to the surrounding breast tissues, it’s called “ductal carcinoma in situ” (DCIS). This is considered stage 0. This type of cancer is treated with surgical removal of the tumor(s) and nipple, followed by radiation.

When ductal carcinoma does spread beyond the milk ducts, it’s called infiltrating or invasive ductal carcinoma. This cancer progresses in stages. In the early stages, you can still treat it by removing the affected breast tissue and axillary lymph nodes. Invasive breast cancer becomes more aggressive and difficult to treat in the later stages when it spreads beyond the breast.