Paget's disease of the breast: understanding symptoms, diagnosis, and treatment

• November 10, 2024
• By Fernando Amato

Paget's disease of the breast is a rare form of cancer that affects the skin of the areola and nipple, often associated with other underlying types of breast cancer, such as ductal carcinoma. This cancer accounts for approximately 1-4% of breast cancer cases and generally occurs in women over 50 years old. Therefore, knowing the signs and seeking an early diagnosis are essential steps for adequate treatment and a better prognosis.

📝 Article Highlights:

🔍 Rare disease often associated with breast cancer.

🚨 Signs like scaling and itching on the nipple are warnings.

🏥 Diagnosis may include mammography, biopsy, and physical examination.

💊 Treatments involve surgery, radiotherapy, and sometimes chemotherapy.

👩‍⚕️ Importance of medical follow-up for early diagnosis.

What is Paget's Disease of the Breast?

Paget's disease of the breast is characterized by the involvement of the nipple and areola by cancer cells. Although this condition may appear to be merely a dermatological alteration, such as a rash or dermatitis, it is usually a sign of an underlying malignant tumor. It is estimated that more than 90% of cases are associated with ductal carcinoma in situ or invasive carcinoma.

Symptoms of Paget's Disease of the Breast

Symptoms of Paget's disease of the breast often include changes in the skin around the nipple and areola. Some of the most common signs and symptoms are: scaling or crusting in the areola and nipple area, intense and persistent itching, a burning sensation or pain in the nipple, redness or swelling around the area, discharge from the nipple, which may be yellow or bloody, and changes in the shape or size of the nipple, including retraction. These symptoms can resemble dermatological problems, but the persistence or worsening of the signs indicates the need for medical evaluation. If you identify such changes, it is essential to seek a specialist for an accurate diagnosis.

How is Paget's Disease Diagnosed?

Diagnosing Paget's disease of the breast involves a combination of physical examination, imaging tests, and tissue analysis. The process generally includes a clinical examination to evaluate the breast and symptoms by the doctor; mammography and ultrasound to assess for underlying tumors; skin or nipple biopsy, which is the removal of a small sample of the affected area for analysis; and, in some cases, magnetic resonance imaging (MRI), recommended to evaluate the extent of the disease and identify underlying tumors that other exams cannot detect. These tests help the doctor confirm the presence of cancer and plan the most appropriate treatment. Early detection is crucial, as Paget's disease can be associated with more invasive tumors.

Treatment for Paget's Disease of the Breast

Treatment for Paget's disease of the breast varies depending on the extent of the disease and the presence of underlying tumors. The most common approaches include: surgery, which may be a total or segmental mastectomy, depending on the tumor's extent; radiotherapy, especially indicated when the tumor is localized only to the areola and nipple, which can reduce the risk of recurrence; and, in some cases, chemotherapy and additional therapies, such as hormone therapies with tamoxifen or aromatase inhibitors, recommended as appropriate. Treatment is planned individually, based on the patient's exams and health history. Consulting an oncologist or a mastologist is essential for an informed and safe decision.

Prognosis of Paget's Disease of the Breast

The prognosis depends on several factors, such as the stage of the underlying tumor and the speed of diagnosis. When diagnosed and treated early, especially if restricted to the nipple area, the chances of cure are higher. However, if the cancer is present in the inner layers of the breast, treatment may be more complex.

Post-Treatment Care and Follow-up

After treatment, regular follow-up is important to monitor for possible recurrence or new lesions. Periodic examinations, such as mammograms and follow-up appointments, help in the early identification of any changes.

Prevention and Early Diagnosis of Paget's Disease of the Breast

Although there are no specific methods to prevent Paget's disease of the breast, adopting certain practices can help in early detection and breast health care. Regular self-examination and periodic consultations with a mastologist are fundamental, as is performing an annual mammogram for women starting at age 40. Early diagnosis is the best ally for more effective treatment.

Frequently Asked Questions

1. What is Paget's disease of the breast?

It is a rare type of cancer that affects the skin of the nipple and areola, often associated with malignant breast tumors.

2. What are the symptoms of Paget's disease?

Scaling, itching, redness, and nipple discharge are common symptoms.

3. Is Paget's disease always cancer?

Yes, it is a form of breast cancer that affects the nipple and areola area.

4. Which test confirms Paget's disease?

Biopsy of the affected area is the definitive test to confirm the diagnosis.

5. Can Paget's disease spread?

Yes, especially if associated with invasive tumors.

6. How is Paget's disease of the breast treated?

Treatments include surgery, radiotherapy, and, in some cases, chemotherapy.

7. Is there a cure for Paget's disease?

Yes, especially if diagnosed early and treated appropriately.

8. What is the importance of mammography in the diagnosis of Paget's?

Mammography assists in detecting underlying tumors, which are frequent in these cases.

9. Does self-examination help detect Paget's?

It can help identify suspicious changes, but diagnosis requires medical examinations.

10. Should I see a specialist if I notice symptoms?

Yes, any changes in the areola or nipple should be evaluated by a mastologist.

Keywords

#Paget #nipple #areola #breast #breastcancer

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