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  • Paget Disease of Breast

Paget Disease of the Breast – Symptoms, Diagnosis & Treatment | I D Cancer Center

What Is Paget Disease of the Breast?

Paget disease of the breast is a rare type of breast cancer that starts in the nipple ducts and spreads to the nipple and areola skin. It often resembles eczema or dermatitis, making early diagnosis challenging.
Most women with Paget disease also have underlying ductal carcinoma, either in situ (DCIS) or invasive cancer.

Who Is at Risk?

While anyone can develop Paget disease, it is more common in:

  • Women above 50 years of age

  • Individuals with personal or family history of breast cancer

  • Those with genetic mutations (BRCA1/BRCA2)

  • Patients with a history of atypical breast lesions

Common Signs & Symptoms

Paget disease usually affects one breast. Key warning signs include:

  • Persistent itching, redness, or flaking of the nipple

  • Nipple discharge (yellowish or bloody)

  • Burning or tingling sensation

  • Nipple flattening or inversion

  • Localised lump or thickened area in the breast

  • Persistent eczema-like patch on the nipple that does not improve with creams

Important: If nipple eczema does not improve in 2–3 weeks, specialist evaluation is needed.

How Is Paget Disease Diagnosed?

Accurate diagnosis requires a combination of clinical evaluation and imaging. At I D Cancer Center, we follow a structured approach:

✔️ Clinical Breast Examination

Detailed assessment of nipple changes and breast tissue.

✔️ Mammography & Breast Ultrasound

Detects underlying lumps or suspicious areas.

✔️ Breast MRI

Used when imaging is unclear or for detailed evaluation.

✔️ Biopsy (Gold Standard)

  • Punch biopsy / wedge biopsy of the nipple–areola

  • Confirms the presence of Paget cells

Treatment Options at I D Cancer Center

Treatment is personalised depending on:

  • Extent of disease

  • Presence of underlying tumor

  • Breast size, patient preference

  • Stage of cancer

1. Breast-Conserving Surgery

Removal of the tumor (with nipple–areola complex) while preserving the breast, followed by radiation therapy.

2. Mastectomy

Recommended when:

  • Tumor is large

  • Multiple cancer areas

  • Recurrence

3. Radiation Therapy

Used after breast-conserving surgery to destroy remaining cancer cells and reduce recurrence risk.
At I D Cancer Center, we offer:

  • IMRT

  • VMAT / Arc Therapy

  • SIB / Hypofractionated RT

  • 3DCRT

4. Chemotherapy

Given if invasive cancer or lymph node involvement is present.

5. Hormonal Therapy

For hormone receptor–positive tumors.

6. Targeted Therapy

HER2-positive tumors benefit from drugs like trastuzumab.

Prognosis

When detected early, Paget disease of the breast has an excellent prognosis.
Outcomes depend on:

  • Presence of invasive cancer

  • Lymph node involvement

  • Treatment type

Regular breast screening improves early detection and survival.

Why Choose I D Cancer Center, Lucknow?

  • Expert care by Dr. Sunil Kumar, HOD & Associate Professor

  • Latest radiotherapy technology (IMRT, VMAT, SRS, SBRT)

  • Multidisciplinary tumor board for personalised treatment

  • State-of-the-art diagnostic and oncology services

  • Patient-centred, compassionate care