Paget's disease of the nipple 

Introduction 

Breast cancer: Emma's story

Emma Duncan, 33, talks about her experience of having breast cancer.

Media last reviewed: 02/10/2013

Next review due: 02/10/2015

How common is Paget’s disease?

Paget’s disease of the nipple affects 1-2 women out of every 100 women with breast cancer.

It usually affects women in their 50s or older, although it can occur at a younger age. Paget’s disease can also affect men, though this is rare.

Breast cancer is the most common type of cancer that affects women in the UK. In 2009, 48,417 women and 371 men were diagnosed with breast cancer.

Breast cancer symptoms

Not all breast changes mean breast cancer, but some do. Know what to look out for, such as changes in shape

Paget’s disease of the nipple, also known as Paget’s disease of the breast, is a rare type of breast cancer.

It produces eczema-like symptoms, appearing as an itchy, red rash on the nipple that can extend to the darker area of surrounding skin (the areola).

The term Paget’s disease of the nipple is used to distinguish the condition from Paget’s disease of the bone, which occurs when the normal cycle of bone growth is disrupted, leading to the bones becoming weak and deformed.

A similar type of skin cancer can also occur in other parts of the body.

The rest of this section will use the term Paget’s disease to refer to Paget’s disease of the nipple or breast.

Symptoms of Paget's disease

Paget's disease usually affects the skin of one nipple, which may be red, dry, sore or scaly. Other possible symptoms include:

  • itchiness or a burning sensation
  • bleeding
  • discharge from the nipple, which may be streaked with blood

However, if itchiness, burning or bleeding occur on their own, it is unlikely you have Paget's disease of the nipple.

Read more about the symptoms of Paget's disease.

Causes of Paget's disease

Paget’s disease is usually a sign of breast cancer in tissue behind the nipple, or other parts of the breast away from the nipple. The breast cancer can either be:

  • invasive - where cancerous cells invade the surrounding breast tissue
  • in situ - where the cancerous cells are contained in one or more areas of the breast and are unable to spread

In around half of all cases of Paget’s disease, a lump is found in the breast. About 9 out of 10 people with a lump will have invasive breast cancer.

Of those who do not have a lump, 4 out of 10 people will have invasive breast cancer, and the rest will have in situ breast cancer.

Read about the causes of Paget's disease.

Diagnosing Paget's disease

You should visit your GP if you notice any changes in the skin of your nipple or areola (the darker area of skin around the nipple).

As Paget’s disease is a form of breast cancer, the sooner it is diagnosed, the better the outcome is likely to be.

See your GP if you develop a lump in your breast. While most breast lumps are not cancerous, it is important you have it checked out.

Read more about how Paget's disease is diagnosed.

Treating Paget's disease

Paget’s disease is treated in the same way as breast cancer. Surgery is usually the first line of treatment but unlike other forms of breast cancer, it involves removing breast tissue that includes the nipple and areola. This may be followed by a combination of:

  • chemotherapy - where powerful medication is used to destroy cancerous cells
  • radiotherapy - where controlled doses of high-energy radiation are used to destroy cancerous cells
  • biological or hormone therapy - which can be used to treat certain types of cancer 

If Paget's disease is detected and treated in its early stages, there is a good chance of recovery. Read more about how Paget's disease is treated.

Preventing Paget's disease

Modifying certain lifestyle factors, such as diet and exercise, may reduce your risk of developing certain types of cancer, including breast cancer.

Screening is also used to help identify women who may have an increased risk of developing breast cancer. The NHS Breast Screening Programme provides free breast screening every three years for all women in the UK who are 50 years of age or over.

Read more about preventing Paget's disease and breast cancer.

Page last reviewed: 19/07/2012

Next review due: 19/07/2014

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