Nipple Rash

QUESTION: I have had two instances of a dry scaly rash covering a very small part of one breast, near the nipple. The first time it sort of went away by itself. The second time, my healthcare provider offered a cream to apply externally (steroid?) and suggested a biopsy if it didn't completely cure it. She suggested that such a rash was sometimes the beginning of a particular type of cancer. Well, it did go away but I'm concerned. Do you have any information about this?

ANSWER: A scaly, rough, sometimes itchy rash on one nipple that persists despite various creams may still be benign (not a cancer). But it also may possibly be an unusual type of breast cancer, called Paget's disease. Paget's disease of the breast usually starts with a rash. Over time, it can grow along the main milk pipes that drain out to the nipple. Caught early, it can be very curable. The fact that your rash went away completely when treated with steroid cream very likely means that it isn't serious. If the rash comes back or persists in any way, your doctor's recommendation to get a biopsy is a good idea.

—Marisa Weiss, M.D.