What are the signs and symptoms?
The main sign of Paget’s disease of the nipple is a change in the nipple and/or areola, including
- the nipple area might become hard, lumpy or crusty – it may look like dermatitis or eczema
- the nipple area might appear red or angry-looking
- there may be an ulcer
- the nipple might flatten out, or turn inwards (invert)
- there may be a discharge or bleeding from the nipple
- the area might feel itchy or sore
- there may be a lump in the same breast.
How is Paget’s disease of the nipple diagnosed?
The first step in investigating any breast change is for the doctor to take a medical history and do a physical examination of both breasts.
The next step is a mammogram (X-ray of the breast) and sometimes an ultrasound to look for signs of invasive cancer or DCIS in the breast. This is important as Paget’s disease of the nipple is often a sign that there is a breast cancer elsewhere in the same breast.
In order to diagnose Paget’s disease of the nipple, cells will be removed from the nipple, areola or breast for examination under a microscope. This is called a biopsy and may be done in a number of ways:
- by taking a small scraping of skin from the nipple
- by inserting a fine needle into the breast and removing some cells
- by removing a section of the nipple or areola; this may be done under a local anaesthetic or a general anaesthetic.
The results of the biopsy and other tests are recorded on a pathology report. You may find it useful to keep a copy of the report so that you can refer to it in the future.
