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?
During your clinic appointment, you will be asked all about the breast change or symptom you have noticed, and a full medical history and clinical examination will be carried out. It is very likely that further tests will be arranged on the basis of your symptoms and examination and may include:
- Mammograms (X-ray)
- Breast ultrasound
- NIpple biopsy
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 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 often 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 similar to the treatments outlined above for patients being treated for an invasive breast cancer.
WHAT IS THE PROGNOSIS FOR PAGET’S DISEASE?
The outlook depends upon the associated disease within the breast. If DCIS is the only abnormality identified then the outlook following treatment is excellent. If there is an associated cancer the outlook depends on that. It is important that you are able to discuss this with your surgeon.
Following completion of treatment for Paget’s disease you will be offered at least 5 years of surveillance with annual mammograms.
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