Paget's Disease: Symptoms and Diagnosis

Paget's disease causes the skin on and around the nipple to become red, sore, and flaky, or scaly. At first, these symptoms tend to come and go.

Over time, symptoms of Paget's disease usually worsen and may include:

• itching, tingling, and/or a burning sensation
• pain and sensitivity
• scaling and thickening of the skin
• flattening of the nipple
• yellowish or bloody discharge from the nipple

Because Paget's disease of the nipple is rare, doctors often mistake it for eczema (severe skin rash and inflammation), an infection or injury, or some other skin condition. For many people, it can take several months to get a correct diagnosis. If you have any of the above symptoms and they persist in spite of treatment, get them checked out by a breast specialist. In most cases, Paget's disease affects one breast, not both.

Diagnosing Paget's disease usually involves the following steps:

• A physical examination of the breasts, with special attention paid to the area around the nipple. Your doctor may be able to feel a lump or mass in the breast.
• A mammogram to check the nipple area and also to look for evidence of cancer in other areas of the breast.
• Ultrasound and/or breast MRI to create additional images of the breast and check for other areas of cancer.
• Biopsy of the nipple and areola. A breast surgeon will perform minor surgery to remove a small piece of tissue from the nipple and areola area and examine it under a microscope. If there is unusual discharge from the breast, your doctor will take a sample of that for examination as well.