Paget Disease of the Nipple

Paget disease of the nipple is a rare type of breast cancer involving the skin of the nipple. Paget disease starts in the breast ducts and spreads to the skin of the nipple and then to the areola, the dark circle around the nipple. Paget disease usually affects only one nipple. It’s usually linked to either ductal carcinoma in situ (DCIS) or infiltrating ductal carcinoma.

Paget disease can look very similar to eczema (very dry skin) of the nipple. Your physician may try to treat this as eczema first, and if it does not improve, recommend a biopsy.

What are the signs and symptoms of Paget disease of the nipple?

The skin of the nipple and areola often looks crusted, scaly, and red. There may be blood or yellow fluid coming out of the nipple. Sometimes the nipple looks flat or inverted. It also might burn or itch.

How is Paget disease of the nipple diagnosed?

Most people with Paget disease of the nipple also have tumors in the same breast. One or more of the following imaging tests may be done to check for other breast changes:

Paget disease of the nipple is diagnosed by a biopsy, removing a small piece of the breast tissue and looking at it in the lab. In some cases, the entire nipple may be removed. Only a biopsy can tell for sure that it is cancer.

How is Paget disease of the nipple treated?

Paget disease can be treated by removing the entire breast (mastectomy) or breast-conserving surgery followed by whole-breast radiation therapy.

If no lump is felt in the breast tissue, and your biopsy results show the cancer has not spread, the outlook (prognosis) is excellent.

If the cancer has spread (is invasive), the outlook is not as good, and the cancer will be staged and treated like any other invasive ductal carcinoma

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Morrow M, Burstein HJ, and Harris JR. Chapter 79: Malignant Tumors of the Breast. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2015.

Last Medical Review: September 25, 2017 Last Revised: September 25, 2017

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