Paget’s disease is a relatively uncommon type of breast cancer that occurs in the mammary ducts adjacent to the nipple and areola skin, and is usually associated with ductal carcinoma in situ (DCIS) within the breast tissue.
WHAT ARE THE SYMPTOMS OF PAGET’S DISEASE?
HOW IS PAGET’S DISEASE DIAGNOSED?
Patients who present to a specialist with symptoms or signs of Paget’s disease will be offered investigations with mammograms and ultrasound, and a tissue biopsy to make the diagnosis. The biopsy is normally done under local anaesthetic in the outpatient clinic, and will send a small sample of the affected skin away to be examined under the microscope to make the diagnosis.
WHAT IS THE TREATMENT FOR PAGET’S DISEASE?
If Paget’s disease is localised to the central part of the breast in the milk ducts around the nipple and areola, then a wide local excision can be offered with surgical removal of the nipple and areola and a margin of healthy tissue around the edge of the disease. Radiotherapy to the breast may be offered to the patient following surgery depending on the size of the affected area found.
If any associated DCIS is more widespread within the breast then a mastectomy may be necessary, but could be combined with an immediate breast reconstruction
If any small areas of invasive breast cancer are identified within the tissue removed, then additional treatment may be offered to the patient, similar to what would be offered for patients being treated for an invasive breast cancer.
WHAT IS THE PROGNOSIS FOR PAGET’S DISEASE?
If DCIS is the only abnormality identified then the prognosis or outlook following treatment is excellent. Other areas of disease identified within any tissue removed may also have an impact on this however, and it is important that you are able to discuss this with your surgeon.
Following treatment for Paget’s disease you will be offered annual mammograms to both breasts to ensure that no further abnormalities occur after treatment.
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