Paget's Disease of the Nipple
How Is Paget’s Disease of the Nipple Diagnosed?
If a health care provider suspects Paget’s disease of the nipple, cytology is performed by testing the nipple discharge. If the test is negative, a biopsy of the nipple skin is performed. In a biopsy, the doctor removes a small sample of tissue that is examined for the presence of Paget's cells.
Because most people with Paget’s disease of the nipple also have underlying breast cancer, a physical exam, mammography (X-ray of the breast), and possible a breast MRI scan are used to make a complete diagnosis.
How Is Paget’s Disease of the Nipple Treated?
Surgery is the most common treatment for Paget’s disease of the nipple. The specific treatment often depends on the characteristics of the underlying breast cancer.
A modified radical mastectomy may be recommended when invasive cancer or extensive ductal carcinoma in situ (DCIS) has been diagnosed. In this operation, the surgeon removes the breast, the lining over the chest muscles, and samples of the lymph nodes under the arm. In cases where underlying breast cancer is not invasive, the surgeon may perform a simple mastectomy to remove only the breast and the lining over the chest muscles.
Alternatively, patients whose disease is confined to the nipple and the surrounding area may undergo breast-conserving surgery or lumpectomy followed by radiation therapy. During breast-conserving surgery, the surgeon removes the nipple, areola, and the entire portion of the breast believed to contain the cancer. In most cases, radiation therapy is also used to help prevent recurrence of the cancer.