How effective is mastectomy for Paget disease of the breast?

Paget disease affects the nipple and areola and can occur with an underlying tumour. Imaging, a biopsy, and examination help show whether the disease is confined to the nipple area or extends through the breast. When the affected area is broad, in more than one place, or associated with an underlying tumour, mastectomy may offer a suitable way to remove the involved tissue.

The operation may include lymph-node assessment. The final pathology report helps decide whether hormone therapy, chemotherapy, radiotherapy, or another treatment is needed. Mastectomy treats the tissue removed during surgery, so follow-up remains part of care.

Ask whether breast imaging and sampling have identified an underlying tumour, which lymph nodes need assessment, and whether reconstruction is appropriate. Discuss the scar, chest sensation, drains, pain control, and how long arm movement may be limited.

At home, keep the incision and drain area as instructed, attend wound and pathology reviews, and perform prescribed shoulder exercises. Report a new fluid collection, increasing redness, fever, wound opening, or pain that is becoming harder to control.

Contact your surgical team for fever, pus, spreading redness, unexpected swelling, persistent bleeding, or a drain that changes suddenly. Seek urgent care for severe chest pain, major bleeding, fainting, or difficulty breathing.

Is Paget disease confined to the nipple area or is there an underlying tumour? Why is mastectomy recommended instead of another surgical approach? Will lymph nodes be assessed? What will pathology determine? What reconstruction or prosthesis options can I consider?