Does lumpectomy treat Paget disease of the breast?

Paget disease affects the skin of the nipple and often involves an underlying breast abnormality. Assessment usually combines examination, breast imaging, and tissue sampling. The surgeon needs to know whether disease is limited to the nipple region or extends into the breast, because that changes the amount of tissue needing removal.

When breast-conserving surgery is suitable, the nipple and areola area may be removed together with the underlying lesion and a margin. The final pathology checks the edges of the specimen and identifies features that guide further treatment. The breast's appearance may change, especially around the nipple.

Ask the breast team to explain the imaging map, the planned specimen, and whether lymph nodes need assessment. Radiotherapy or medicines may be recommended after surgery depending on the pathology and any underlying cancer. If disease is widespread, margins cannot be cleared, or breast preservation would be unsafe, a more extensive operation may be discussed.

Bring up reconstruction, nipple appearance, wound care, and the emotional effect of visible changes before choosing an operation. A breast surgeon can explain how each option balances cancer removal with the result you want.

Have persistent crusting, scaling, redness, burning, inversion, or discharge from one nipple assessed, particularly when treatment for infection has not resolved it. After surgery, contact the team for fever, spreading redness, increasing swelling, drainage, wound separation, or pain that is getting worse. Seek urgent help for heavy bleeding, fainting, chest pain, or severe breathlessness.

Is the disease limited to the nipple and areola? Is there an underlying tumour? Can lumpectomy remove all affected tissue with a clear margin? Will lymph nodes be sampled? Is radiotherapy expected? What changes to the nipple or breast should I plan for, and what reconstruction choices are available?