Paget’s Disease Of The Breast Or Nipple
Paget’s disease of the breast (nipple) is a rare condition with causes associated with breast cancer. This condition looks like hard, crusty, scaly skin on the nipple or areola. The early stages begin with symptoms such as irritation and itchy areola. The disease takes its name from the great English surgeon and pathologist Sir James […] Read More
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Paget’s Disease Of The Breast Or Nipple
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What is Paget’s Disease Of The Breast?
Picture Courtesy: pathology.com
Paget’s disease of the breast, otherwise called Paget’s disease of the nipple, is a rare medical condition connected with the breast. The disease is a combination of scaly skin changes of the nipple, which is eczema-like, and cancer of the breast.
The nipple is inflamed because of the presence of Paget’s cells. The large irregular cells (Paget’s cells) are not cancerous but are almost associated with cancer in the breast. The 1-4% of the women diagnosed with breast cancer have Paget’s disease of the nipple. It can affect the men also but in extremely rare cases.
How is Paget’s disease of the breast diagnosed?
Diagnosis
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The patient should consult the surgeon once she starts noticing any abnormal signs in the breast. The doctor will examine the patient and records the medical history and family history, and carry out a physical examination of the breast.
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Some tests for diagnosis include:
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- A mammogram; is an X-ray to visualize normal and abnormal structures within the breast.
- Breast MRI (a scan to study the detailed picture of the breast)
- Breast Ultrasonography (uses soundwaves to take pictures of the breast)
- Biopsy; to examine the skin and underlying breast tissue for abnormalities. There are several types of nipple biopsy that a doctor can advise based on the patient’s condition. Few are listed below:
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- Surface Biopsy: A glass slide or other tool is used to scrape the cells from the skin’s surface gently.
- Shave Biopsy: A razor-like tool is used to shave the top layer of the skin.
- Punch Biopsy: A circular cutting tool called a punch is used to remove disc-shaped pieces of the tissue.
- Wedge Biopsy: A scalpel (surgical knife) is used to remove a small wedge of the tissue.
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How is Paget’s disease of the breast treated?
Treatment Treatments of Paget’s disease of the breast or nipple are often targeted at the cancer cells in the breast that likely result in the disease, and not specifically at the disease. The following can be used to control and manage the condition:-
Surgery
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Radiotherapy
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Chemotherapy
- Hormonal therapy
What are the most common complications associated with Paget’s disease of the breast or nipple?
Complications Breast cancer treatment usually consists of a combination of therapies that have several side effects. Surgery, radiotherapy, chemotherapy, and hormone treatments can lead to temporary complications such as:-
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- Fatigue
- Pain and numbness (peripheral neuropathy)
- Skin irritation.
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- Lymphedema; is a lymphatic dysfunction that causes the lymphatic system to function poorly due to removing the lymph nodes and vessels.
- Increased risk of other cancers as a result of chemotherapy or radiotherapy.
- Early menopause or inability to conceive due to hormone therapy or chemotherapy.
- Bone loss (osteoporosis)
- Infertility
- Blood clots
- Heart problems
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What is the prognosis for people with Paget’s disease of the breast?
Prognosis If a Paget’s disease of the breast patient has no tumors or lymph node involvement, htheiris/her prognosis stands a better chance. The survival rate may be reduced in case of invasive cancer that spreads to the lymph nodes.Self-care At Home
The following personal care tips can help you control and manage the condition and its symptoms. They include:-
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- Take the medications exactly as prescribed.
- Consult the doctor immediately whenever the patient feels some kind of problem with the medications or health.
- Eat healthy foods.
- Do a lot of physical activities, but keep from getting too exhausted.
- Do not smoke.
- Avoid intake of alcohol.
- Take steps to control stress and workload.
- Get enough sleep and take time to do things that makes a person feel happy.
- Drink lots of fluid, especially water.
- Eat clear soups, mild foods, and liquids. Other good choices include dry toast, cooked cereal, crackers, and gelatin dessert.
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Symptoms
What are the most common symptoms associated with Paget’s disease of the breast or nipple?
Picture Courtesy: breast cancer
The early symptoms associated with this disease are that the nipple and areola (surrounding skin) become irritational and itchy and turns typically red and inflamed.
Other signs include:
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- Tough crusty (eczema-like) areola
- The nipple may be turned inwards.
- Yellowish or bloody discharge from the nipple.
- Increase in breast sensitivity, soreness, and pain in the breast.
- Bleeding.
- Ulceration of the surrounding skin.
- Lump underneath the nipple in the breast.
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Symptoms that do not involve the breast include:
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- Fatigue and increased stress level.
- Dehydration
- Diarrhea
- Nausea and vomiting
- Lack of appetite.
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Causes
What are the causes of Paget’s disease of the breast?
Paget’s cells remain a mystery, as the reasons behind their formation are not known.
For now, the most accepted theory is that the disease results from underlying ductal breast cancer. The milk ducts transport the cancerous cells from the original tumors to the nipple and its surrounding skin. The second theory is that the cells in the nipple or areola of the breast become cancerous.
FAQ
What does Paget’s breast disease look like?
Paget’s disease can affect the breasts, making the nipples (and the surrounding dark skin) irritated and inflamed. This causes tough, crusty, and scaly skin, looking like eczema.
Is Paget’s disease of the breast curable?
Paget’s disease of the breast can be treated by mastectomy (removal of the entire breast) or breast-conserving surgery (BCS) followed by whole-breast radiotherapy. After BCS is complete, the nipple and areola must be removed.
Is Paget’s disease fatal?
Paget’s disease of the breast can be fatal if early attention is not given to it. Sometimes, symptoms may not be observed, which can hinder early treatment. The survival rate may decline when the lymph nodes are affected (invasive cancer in the breast). All the breast needs are removed at this stage and may lead to complications associated with the long-term risk of lymphedema, early menopause, and infertility.
How aggressive is Paget’s disease of the breast?
Paget’s disease, a non-invasive type of cancer, is not considered aggressive. It is often associated with other cancers in the breast.
How can you prevent Paget’s disease of the breast?
To prevent Paget’s disease of the breast, the patient has to follow the instructions carefully. A few of them are listed below:
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- Eat healthy foods.
- Maintain a healthy weight.
- Do regular exercises.
- Reduce alcohol consumption.
- Do not smoke or take hard drugs.
- Have regular breast checks and regular mammograms for early detection to prevent the spread of the disease.
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What foods increase breast size?
Milk contributes to the growth of breast tissues. Cow milk is enriched with estrogen, progesterone, and prolactin and is required to produce milk in women, this enhancing their breast size.
Green leafy vegetables should also form part of the daily diet to boost breast size.
What are the risk factors associated with Paget’s disease of the breast or nipple?
The risk factors associated with Paget’s disease are listed below:
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- Age- the risk of breast cancer increases with age (>50 years)
- History of breast cancer or any other breast abnormality
- Family history
- Inherited genes such as BRCA1 or BRCA2 genes increase the chances of getting cancer.
- Radiation exposure
- Obesity, alcohol intake
- Women who have never been pregnant
- Postmenopausal hormonal therapy.
- Having a first child at an older age.
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