Paget’s disease of the breast
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Breast and nipple changes can be a sign of breast cancer. Make an appointment with your doctor if you notice anything unusual.
Paget’s (PAJ-its) disease of the breast is a rare form of breast cancer. Paget’s disease of the breast starts on the nipple and extends to the dark circle of skin (areola) around the nipple. Paget’s disease of the breast isn’t related to Paget’s disease of the bone, a metabolic bone disease.
Paget’s disease of the breast occurs most often in women older than age 50. Most women with Paget’s disease of the breast have underlying ductal breast cancer, either in situ — meaning in its original place — or, less commonly, invasive breast cancer. Only in rare cases is Paget’s disease of the breast confined to the nipple itself.
Paget’s disease of the breast affects your nipple and usually the skin (areola) surrounding it. It’s easy to mistake the signs and symptoms of Paget’s disease of the breast for skin irritation (dermatitis) or another noncancerous (benign) skin condition.
Possible signs and symptoms of Paget’s disease of the breast include:
Signs and symptoms usually occur in one breast only. The disease typically starts in the nipple and may spread to the areola and other areas of the breast.
The skin changes may come and go early on, or respond to topical treatment, making it appear as if your skin is healing. On average, women experience signs and symptoms for several months before getting a diagnosis.
Be aware of any changes in your breasts. If you feel a lump in your breast, or if you experience itching or skin irritation that persists for more than a month, make an appointment with your doctor.
If you’re being treated for a skin injury on your breast, and the condition doesn’t go away with treatment, make a follow-up appointment with your doctor. You may need a biopsy — a procedure that collects a small tissue sample for microscopic analysis — to evaluate the affected area.
Doctors don’t know what causes Paget’s disease of the breast. The most widely accepted theory is that the disease results from an underlying ductal breast cancer. The cancer cells from the original tumor then travel through milk ducts to the nipple and its surrounding skin. Another theory is that the disease can develop independently in the nipple.
Risk factors that affect your likelihood of developing Paget’s disease of the breast are the same factors that affect your risk of developing any other type of breast cancer.
Some factors that make you more susceptible to breast cancer include:
Having one or more risk factors doesn’t necessarily mean you’ll develop breast cancer. Most women with breast cancer have no known risk factors.
Making changes in your daily life may help reduce your risk of breast cancer. Try to:
Ask your doctor about breast cancer screening. Discuss with your doctor when to begin breast cancer screening exams and tests, such as clinical breast exams and mammograms.
Talk to your doctor about the benefits and risks of screening. Together, you can decide what breast cancer screening strategies are right for you.
Become familiar with your breasts through breast self-exam for breast awareness. Women may choose to become familiar with their breasts by occasionally inspecting their breasts during a breast self-exam for breast awareness. If there is a new change, lumps or other unusual signs in your breasts, talk to your doctor promptly.
Breast awareness can’t prevent breast cancer, but it may help you to better understand the normal changes that your breasts undergo and identify any unusual signs and symptoms.
Limit postmenopausal hormone therapy. Combination hormone therapy may increase the risk of breast cancer. Talk with your doctor about the benefits and risks of hormone therapy.
Some women experience bothersome signs and symptoms during menopause and, for these women, the increased risk of breast cancer may be acceptable in order to relieve menopause signs and symptoms.
To reduce the risk of breast cancer, use the lowest dose of hormone therapy possible for the shortest amount of time.
If your doctor has assessed your family history and other factors and determined that you may have an increased risk of breast cancer, options to reduce your risk include:
Preventive medications (chemoprevention). Estrogen-blocking medications may help reduce the risk of breast cancer. Options include tamoxifen and raloxifene (Evista). Aromatase inhibitors have shown some promise in reducing the risk of breast cancer in women with a high risk.
These medications carry a risk of side effects, so doctors reserve these medications for women who have a very high risk of breast cancer. Discuss the benefits and risks with your doctor.
Discuss your personal risk factors with your doctor and ask whether you would be a candidate for treatment that may reduce that risk.
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Paget’s disease of the breast
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