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Paget Disease of the Breast
Paget disease of the breast, also known as Paget disease of the nipple, is a rare type of breast cancer involving the skin of the nipple and the areola (the dark circle around the nipple).
Signs and symptoms of Paget disease of the breast
The symptoms of Paget disease can often be like those of eczema or other skin conditions:
- The skin of the nipple and areola often looks crusted, scaly, and red.
- The skin around the nipple might burn or itch.
- There may be blood or yellow fluid coming out of the nipple.
- Sometimes the nipple looks flat or inverted.
Paget disease usually affects only one breast.
Your doctor might try to treat this as eczema first, and, if it does not improve, recommend a biopsy.
In most cases, Paget disease is found along with either ductal carcinoma in situ (DCIS) or infiltrating ductal carcinoma (invasive breast cancer) in the underlying breast. This can sometimes be felt as a lump in the breast.
How is Paget disease of the breast diagnosed?
Most people with Paget disease of the breast 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 might be suspected based on a physical exam or the results of imaging tests, but only a biopsy can show for sure whether the abnormal area is cancer.
Paget disease of the breast is often diagnosed by a skin biopsy, in which a small piece of the affected area is removed and looked at in the lab. This can be done in different ways:
- Surface biopsy, where a glass slide or other tool is used to scrape cells from the skin
- Shave biopsy, where a small surgical blade is used to remove the top layers of skin
- Punch biopsy, where a tool that looks like a tiny circular cookie cutter is used to remove a deep sample of skin
- Incisional or wedge biopsy, where a scalpel is used to remove a small wedge of skin
If a breast lump is either felt or seen on an imaging test, it will be sampled as well during a breast biopsy, which can be done in different ways.
If cancer is found, other tests will be done on the biopsy samples to learn more, which might affect treatment options. To learn more, see Understanding a Diagnosis of Breast Cancer.
Treating Paget disease of the breast
Paget disease is typically treated by either removing the entire breast (mastectomy) or with breast-conserving surgery followed by whole-breast radiation therapy, if all of the cancer can be removed while maintaining an acceptable appearance.
If breast-conserving surgery is done, the entire nipple and areola need to be removed. If invasive cancer is found, the lymph nodes under the arm will be checked for cancer.
If invasive cancer is found in the breast tissue, the cancer will be staged and treated like any other invasive breast cancer. This might include further treatment with hormone therapy, chemotherapy, or targeted therapy, depending on the stage of the cancer and the results of tests done on the cancer cells.
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- References
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
Henry NL, Shah PD, Haider I, Freer PE, Jagsi R, Sabel MS. Chapter 88: Cancer of the Breast. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier; 2020.
National Cancer Institute. Paget Disease of the Breast. 2025. Accessed at https://www.cancer.gov/types/breast/breast-cancer-types/paget-disease-breast on April 9, 2026.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Breast Cancer. Version 2.2026. Accessed at https://www.nccn.org on April 9, 2026.
Sabel MS, Weaver DL. Paget disease of the breast (PDB). UpToDate. 2026. Accessed at https://www.uptodate.com/contents/paget-disease-of-the-breast-pdb on April 9, 2026.
Last Revised: June 24, 2026
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