The Paget’s disease of breast is a rare form of the breast cancer. This disease starts on the nipple and it extends to the dark circle of the skin (areola) around the nipple. You should know that the Paget’s disease of breast is not related to the Paget’s disease of bones which is a metabolic bone disease. The Paget’s disease of breast is most often happening in women who are older than age 50 [1]. It is known that in the most cases, women who have Paget’s disease of breast have underlying ductal breast cancer either in the original place (situ) or in less common cases, they have invasive breast cancer. There are rare cases when the Paget’s disease of breast is confined to the nipple itself [2].
Paget’s disease of breast Symptoms
Symptoms: This condition is affecting the nipple and the areola (the skin around the nipple). It is very easy to mistake the signs and symptoms of Paget’s disease of breast for dermatitis (skin irritation) or another benign (noncancerous) skin condition. Below are given some of the signs and symptoms of Paget’s disease of breast:
- Thickening skin on the breast
- A lump in the breast
- A flattened or turned – in (inverted) nipple
- Straw – colored or bloody nipple discharge
- A tingling or burning sensation
- Redness
- Itching
- Crusty, oozing or hardened skin resembling eczema on the nipple, areola or both
- Flaky or scaly skin on your nipple
The signs and symptoms of Paget’s disease of breast usually are happening in one breast only. The Paget’s disease of breast typically starts in the nipple and it can spread to the areola and other areas of the breast. The skin changes can come and go early on, or they can respond to the topical treatment which can make you appear as your skin is healing. In the average cases, women are experiencing signs and symptoms for several months before they get a diagnosis. You should be aware of any changes in your breoasts. If you feel that you have a lump in your breast or if you are experiencing skin irritation or itching which persists for more than a month, then you should visit your doctor as soon as possible. If you are being treated for a skin injury on your breast and you have noticed that the Paget’s disease of breast does not go away with treatment, then you should make a follow – up appointment with your doctor. There are some women who may need a biopsy to evaluate the affected area. Biopsy is a procedure which collects a small tissue sample for microscopic analysis.
Paget’s disease of breast
Causes: The cause for Paget’s disease of breast is not known by doctors. The most widely accepted theory is that Paget’s disease of breast is resulting from an underlying ductal breast cancer. The cancer cells from the original tumor are travelling through the milk ducts to the nipple and surrounding area. There is another theory about Paget’s disease of breast and that is this disease can develop independently in the nipple.
Risk factors: It is known that the risk factors which are affecting your chances of getting Paget’s disease of breast are the same factors which are affecting your risk of developing any other type of breast cancer. Here are some factors which are increasing your risk of Paget’s disease of breast:
- Alcohol: If you drink alcohol in large amounts, then it increases the risk of developing Paget’s disease of breast. [3]
- Race: It is known that white women are having more chances to develop breast cancer than Hispanic or black women but black women are having more chances to die of this disease. [4]
- Hormone replacement: If you take estrogen after menopause, then the risk for breast cancer is increased in some women.
- Age: You are having more chances to develop Paget’s disease of breast as you are getting older. [1]
- Dense breast tissue: Those women who have a dense breast tissue, as seen on a mammogram, are having more chances of breast cancer.
- A personal history of breast cancer: It is known that if you had breast cancer in one breast, you have more chances of developing cancer in the other breast. [5]
- Excess weight: If you weight more than normal which is healthy for age, then the risk of breast cancer is increased, especially after menopause if you have gained weight.
References:
[1] National Organization for Rare Disorders (NORD). Paget’s disease of the breast. 2016. Retrieved from rarediseases.org/rare-diseases/pagets-disease-of-the-breast/
[2] Wang J, Liu J, Xing Z, et al. Paget’s disease of the nipple in males: two case reports and literature review. Journal of Bio-X Research. 2018;1(2):89-94.
[3] NCH Healthcare System. Paget’s disease of the breast. 2019. Retrieved from www.nchmd.org/education/mayo-health-library/details/CON-20155351
[4] Andretta Tanaka VD, Sanches JA, Torezan L, et al. Mammary and extramammary Paget’s disease: A study of 14 cases and the associated therapeutic difficulties. Clinics. 2009;64(6):599-606.
[5] Ortiz-Pagan S, Cunto-Amesty G, Narayan S, et al. Effect of Paget’s disease on survival in breast cancer: An exploratory study. Archives of Surgery. 2011;146(11):1267-70.
