Summary about Disease
Paget's disease of the nipple is a rare type of cancer that involves the skin of the nipple and usually the areola (the darker skin surrounding the nipple). It is often associated with an underlying breast cancer, either ductal carcinoma in situ (DCIS) or invasive breast cancer. Less commonly, it can occur independently of an underlying breast cancer.
Symptoms
Redness, scaling, and crusting of the nipple and areola
Itching or burning sensation in the nipple area
Nipple discharge (may be clear, yellow, or bloody)
Flattened or inverted nipple
A lump or thickening in the breast tissue (may or may not be present)
Pain in the breast
Causes
The exact cause isn't fully understood. The most widely accepted theory is that Paget's disease of the nipple occurs when cancer cells from a tumor inside the breast travel through the milk ducts to the nipple and areola. A less common theory suggests that cells in the nipple become cancerous on their own.
Medicine Used
Treatment typically involves surgery to remove the tumor and affected breast tissue. Other treatments may include:
Lumpectomy: Removal of the tumor and a small amount of surrounding tissue. Followed by radiation therapy.
Mastectomy: Removal of the entire breast.
Radiation therapy: Used to kill any remaining cancer cells after surgery.
Hormone therapy: Used if the cancer is hormone receptor-positive.
Chemotherapy: May be used if the cancer has spread to other parts of the body.
Targeted therapy: Drugs that target specific proteins or pathways involved in cancer growth.
Is Communicable
No, Paget's disease of the nipple is not communicable or contagious. It cannot be spread from person to person.
Precautions
There are no specific precautions to prevent Paget's disease of the nipple, as the exact cause is unknown. However, the general recommendation is to follow breast cancer screening guidelines which include:
Regular breast self-exams
Clinical breast exams by a healthcare provider
Mammograms as recommended by a doctor
How long does an outbreak last?
Without treatment, symptoms will persist and potentially worsen. The "outbreak" doesn't resolve on its own. Treatment is essential to address the underlying cancer.
How is it diagnosed?
Physical exam: Doctor examines the breast and nipple.
Mammogram: X-ray of the breast.
Ultrasound: Uses sound waves to create images of the breast.
Biopsy: A small sample of tissue is removed from the nipple and areola and examined under a microscope. This is the definitive diagnostic test.
MRI: If the diagnosis is confirmed, MRI is used to evaluate how much is involved and to see if there is any disease that cannot be seen on mammogram or ultrasound.
Timeline of Symptoms
The timeline of symptoms can vary. In some cases, symptoms appear gradually over several months. In other cases, they may appear more rapidly. The symptoms can include:
Early: Mild itching, redness, or scaling of the nipple.
Later: Persistent itching, burning, crusting, nipple discharge, flattening or inversion of the nipple, and potentially a lump in the breast.
Important Considerations
Because Paget's disease of the nipple is often associated with underlying breast cancer, early diagnosis and treatment are crucial.
It's important to consult a doctor if you notice any changes in your nipple or breast tissue.
Even if you have been treated for Paget's disease of the nipple, regular follow-up appointments are important to monitor for recurrence.
A multidisciplinary team of healthcare professionals, including surgeons, oncologists, and radiation oncologists, is usually involved in the treatment of Paget's disease of the nipple.