17913 Pagets Disease Of The Breast
Informed by recognized medical guidance
Overview
Paget’s disease of the breast is a rare form of breast cancer that starts in the nipple and often affects the darker area around it (the areola). It usually looks like a rash, redness, or crusting on the nipple. In most cases, there is also an underlying breast cancer inside the breast. This is not the same as Paget’s disease of the bone, which is a different condition.
Key facts
- Paget’s disease is a type of breast cancer, not a skin infection.
- It usually affects just one nipple.
- It is often diagnosed early because symptoms are visible on the skin.
- Treatment works well, especially if the cancer is caught before it spreads.
No, it is rare. It affects about 1 to 4 out of every 100 people with breast cancer.
It mostly affects women over age 50, but it can also occur in younger women and, rarely, in men. The average age at diagnosis is around 60.
Symptoms
- Sudden severe chest pain with difficulty breathing
- Coughing up blood
- Fainting or suddenly feeling very weak
- ⚠A new breast lump
- ⚠Bloody discharge from the nipple
- ⚠Sudden worsening of redness, pain, and swelling in the breast area with a fever
Common symptoms
- Redness, crusting, or flaking on the nipple or the areola
- Itching, burning, or tingling in the nipple area
- Yellow or bloody discharge from the nipple
- A flat or inverted nipple
- A lump or thickening in the breast
Symptoms in children
- Paget’s disease does not normally affect children. If a child has nipple redness or crusting, it is usually a harmless skin condition — but you should still have a pediatrician check it.
Symptoms in older adults
- Symptoms are the same as in younger adults. Older adults may also feel unusually tired, lose weight without trying, or notice a new lump. These changes should always be checked by a doctor.
Causes
Main causes
- Experts believe Paget’s disease begins when cancer cells from an underlying breast tumor travel through the milk ducts to the nipple. Less often, the cancer starts directly in the nipple itself.
Risk factors
- Being over 50 years old
- Being female – though men can get it too
- Having a personal or family history of breast cancer
- Inherited changes in genes linked to breast cancer
- Previous radiation treatment to the chest area
When to see a doctor
See a doctor urgently if:
- See a doctor the same day if you find a new breast lump, notice bloody discharge, or have a nipple rash that quickly gets worse and is painful.
Book a routine appointment if:
- Make an appointment with your general practice doctor if you have any persistent nipple change – such as crusting, itching, redness, or a sore – that does not heal within two weeks.
Diagnosis
Your doctor will ask about your symptoms, examine your breasts, and may refer you to a breast clinic for more tests. At the clinic, a specialist will usually perform imaging tests and a biopsy to confirm the diagnosis.
Tests that may be done
- Clinical breast examination – a doctor checks both breasts and the nipples for changes
- Mammogram – an X-ray of the breast to look for underlying tumors
- Ultrasound – uses sound waves to create images of breast tissue
- Nipple biopsy – a small sample of skin from the nipple is taken and checked under a microscope
What to expect at your appointment
The diagnosis process is usually done as an outpatient. Biopsy results may take a few days. If Paget’s disease is confirmed, you will be referred to a breast cancer specialist who will explain your treatment options and answer your questions.
Treatment
Treatment for Paget’s disease of the breast depends on whether there is an underlying breast cancer, how large it is, and whether it has spread. The main treatment is surgery. You may also be offered other treatments to reduce the chance of the cancer coming back.
Self-care at home
- Keep the nipple area clean and dry to avoid added irritation
- Wear a soft, cotton bra and loose clothing
- Avoid scratching the affected area
- Take note of any changes you see and tell your care team
Medical treatments
Surgery is the main treatment. This may involve removing the nipple and areola along with a small margin of healthy tissue, followed by radiation therapy. If the underlying cancer is larger or has spread, a mastectomy (full removal of the breast) may be recommended. Additional treatments may include hormone therapy, chemotherapy, or targeted therapy, depending on the type of cancer and your individual situation. Your doctor will not use any medicines or treatments without fully explaining them first.
When is surgery considered?
Most people with Paget’s disease will have surgery to remove the affected breast tissue. The exact type of surgery depends on the size of the underlying tumor and your overall health.
Living with this condition
After treatment, you will have regular check-ups and follow-up tests. It is normal to feel tired and overwhelmed at times. Allow yourself plenty of rest and ask for help from family, friends, or your care team when you need it.
Lifestyle tips
- Stay active in ways you enjoy, such as walking or gentle stretching
- Try to maintain a healthy weight
- Limit alcohol
- If you smoke, ask your health care team for help to quit
Diet and exercise
Eat a balanced diet with plenty of vegetables, fruits, whole grains, and protein. There is no special diet that cures Paget’s disease, but good nutrition supports your body during and after treatment. Light exercise can improve energy and mood.
Mental health and emotional wellbeing
A breast cancer diagnosis can bring up fear, anxiety, and sadness. These feelings are very common. It is important to talk about how you feel — with your doctor, a counselor, or someone you trust. Your care team can connect you to mental health support.
Prevention
There is no known way to prevent Paget’s disease of the breast. The best thing you can do is pay attention to any changes in your nipples and breasts, and see a doctor if something feels or looks unusual.
Screening programmes
Routine breast screening with mammograms may help detect underlying breast changes before they cause symptoms. Ask your local health service when you are due for a mammogram.
Complications
If left untreated
- The cancer can grow deeper into the breast
- It can spread to lymph nodes under the arm
- It can spread to other parts of the body, such as bones, liver, or lungs
Long-term outlook
Paget’s disease is highly treatable, especially when found early. Many people live long and healthy lives after treatment. Your doctor will give you an honest, individual outlook based on the stage of your cancer and your overall health.
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Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
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Sources and guidance
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: August 2, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.