If you have breast-conserving surgery, as opposed to mastectomy, you will also need to have radiation therapy to the breast to treat Paget's disease. A number of studies have shown that radiation therapy after surgery reduces the risk that the cancer will come back.
If you are having a mastectomy and radiation therapy, you might also be thinking about having breast reconstruction. There are many opinions in the medical community about the timing of reconstruction for people who have radiation therapy. Talk to your doctor about whether it’s best to undergo breast reconstruction before or after radiation.
After you have your surgery and possibly radiation therapy, you may need to have chemotherapy, targeted therapy, and/or hormone therapy. About 97% of people diagnosed with Paget's disease of the nipple also have DCIS or invasive cancer somewhere else in the breast. Your exact treatment plan will depend on the characteristics of the underlying breast cancer — such as stage, grade, and whether or not the cancer is hormone-receptor-positive and/or HER2-positive.
If the Paget's disease was limited to your nipple with no signs of cancer in the lymph nodes, no additional treatment is recommended after radiation therapy.