What are the symptoms of mammary Paget’s disease?

Mammary Paget’s disease, also known as Paget’s disease of the breast, is a rare form of breast cancer that affects the skin of the nipple and areola. The symptoms of Mammary Paget’s disease may include:

1. Redness and itching: The skin of the nipple and areola may appear red, scaly, or crusty. Itching and burning sensations may also occur.
2. Flaking or oozing: The skin of the nipple and areola may flake or peel, and there may be discharge from the nipple that is bloody or clear.
3. Thickening of the skin: The skin of the nipple and areola may become thicker or develop a lump underneath it.
4. Inverted or flattened nipple: The affected nipple may become inverted (pulled inward) or flattened.
5. Pain: Some people with Mammary Paget’s disease may experience pain or a burning sensation in the affected breast.

It’s important to note that these symptoms can also be caused by other, less serious conditions, such as eczema or a skin infection. However, if you experience any of these symptoms, especially if they are persistent or unusual for you, it’s important to see a healthcare provider for an evaluation. Early detection and treatment of breast cancer, including Paget’s disease, can improve outcomes and quality of life.

What are the causes of mammary Paget’s disease?

The exact cause of Mammary Paget’s disease is not well understood, but it is thought to be related to underlying breast cancer. Mammary Paget’s disease is believed to occur when cancer cells from an underlying breast cancer migrate to the skin of the nipple and areola, causing the characteristic symptoms of redness, itching, and flaking.

Most cases of Mammary Paget’s disease are associated with ductal carcinoma in situ (DCIS) or invasive breast cancer elsewhere in the breast. In some cases, the underlying breast cancer may be too small to be detected by imaging studies or physical examination, and Mammary Paget’s disease may be the first sign of an underlying breast cancer.

Risk factors for developing Mammary Paget’s disease are similar to those for developing breast cancer and may include:

1. Age: The risk of developing Mammary Paget’s disease increases with age, with most cases diagnosed in women over the age of 50.
2. Gender: Mammary Paget’s disease is much more common in women than in men.
3. Family history: Women with a family history of breast cancer may have an increased risk of developing Mammary Paget’s disease.
4. Genetic mutations: Mutations in certain genes, such as BRCA1 and BRCA2, can increase the risk of developing breast cancer and may also increase the risk of developing Mammary Paget’s disease.
5. Previous breast cancer: Women who have had breast cancer in one breast are at increased risk of developing breast cancer, including Mammary Paget’s disease, in the other breast.

It’s important to note that not all cases of Mammary Paget’s disease are associated with underlying breast cancer. In rare cases, Mammary Paget’s disease may be noncancerous (benign) and may be caused by inflammatory or infectious conditions of the breast skin. However, most cases of Mammary Paget’s disease are associated with underlying breast cancer, and further evaluation and treatment are usually recommended.

What is the treatment for Mammary Paget’s disease?

The treatment for Mammary Paget’s disease typically involves surgery to remove the affected skin of the nipple and areola, as well as any underlying breast cancer. The extent of surgery will depend on the size and location of the tumor, as well as whether the cancer has spread to other parts of the breast or body. Treatment options may include:

1. Surgery: The most common surgical treatment for Mammary Paget’s disease is a lumpectomy or partial mastectomy, which involves removing the tumor along with a margin of normal tissue. In some cases, a total mastectomy (removal of the entire breast) may be recommended, especially if the cancer is large or if there are multiple tumors in the breast.
2. Sentinel lymph node biopsy: If there is concern that the cancer has spread to the lymph nodes, a sentinel lymph node biopsy may be performed. This procedure involves removing the first few lymph nodes that drain the breast to check for the presence of cancer cells.
3. Radiation therapy: Radiation therapy may be recommended after surgery to destroy any remaining cancer cells and reduce the risk of recurrence. It may also be used as the primary treatment for women who are not candidates for surgery.
4. Chemotherapy: Chemotherapy may be recommended for women with invasive breast cancer to help shrink the tumor before surgery (neoadjuvant chemotherapy) or to reduce the risk of recurrence after surgery (adjuvant chemotherapy).
5. Hormone therapy: Hormone therapy may be recommended for women with hormone receptor-positive breast cancer to block the effects of estrogen on the cancer cells and reduce the risk of recurrence.
6. Targeted therapy: Targeted therapy may be recommended for women with HER2-positive breast cancer to target the HER2 protein on the surface of the cancer cells and reduce the risk of recurrence.
7. Follow-up care: After treatment, women with Mammary Paget’s disease will need regular follow-up care, including physical exams, mammograms, and other imaging tests, to monitor for recurrence or spread of the cancer.

The specific treatment plan for Mammary Paget’s disease will depend on several factors, including the size and location of the tumor, the stage of the cancer, and the overall health and preferences of the patient. It’s important for women with Mammary Paget’s disease to work closely with a healthcare team that specializes in the treatment of breast cancer to develop a personalized treatment plan. Early detection and treatment of Mammary Paget’s disease can improve outcomes and quality of life.

Can you get Mammary Paget’s disease while breastfeeding?

Yes, it is possible to develop Mammary Paget’s disease while breastfeeding, although it is rare. Mammary Paget’s disease of the breast is a rare form of breast cancer that affects the skin of the nipple and the areola. It often presents with symptoms such as itching, redness, scaling, or flaking of the skin on the nipple and areola.

While breastfeeding, it’s important to monitor any changes in the breast, including the nipple and areola, and to report any unusual symptoms to a healthcare provider. Mammary Paget’s disease can sometimes be mistaken for other conditions, so it’s important to have any changes in the breast evaluated by a healthcare professional. If Mammary Paget’s disease is suspected, further tests, such as a biopsy, may be needed to confirm the diagnosis.