Paget's Disease Symptoms

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Paget's Disease Symptoms

Question:

What are the symptoms of Paget's disease of the breast?

Answer:

Paget's disease of the breast is a change in the skin on or around the nipple, and it is caused by cancer. The rash can appear raw, red, weepy (usually with clear yellow fluid), blistered or scaly. It often looks similar to the skin condition eczema. Sometimes the area that is involved with the rash is very small, but it is possible for the rash to involve the nipple and also the areola that surrounds the nipple.

Almost always, when a nipple rash is from Paget's disease, there are actually two cancers in the breast: the rash area contains cancer cells, and there is usually a cancer lump deeper in the breast. Many experts think that the deeper breast cancer forms first, and then cancer cells that develop the ability to travel spread through the ducts of the breast to the nipple, where they create the rash. The two cancers are not made out of identical cells, but usually the cell types are closely related.

There are other things that can cause a rash on the nipple, and not all of them are as dangerous as breast cancer. If there is a worry that a nipple rash is from Paget's disease, a biopsy is needed to diagnose the cancer. A small wedge-shaped sample of the nipple is usually surgically removed for this purpose.

Mary Pickett, M.D., is a lecturer for Harvard Medical School and an assistant professor of medicine at Oregon Health & Science University in Portland, OR. At OHSU, she practices general internal medicine and teaches medical residents and students.

Last updated:	July 20, 2009