How is Paget disease of the breast treated?

The condition affects the nipple and areola and may occur with a separate area of breast cancer. Tests help the breast team understand the extent, tumour features, and lymph-node involvement. A lumpectomy removes the nipple-areola area and the abnormal breast tissue while preserving much of the breast when that approach is suitable. A mastectomy removes the breast when disease is more extensive or breast-conserving surgery would not provide a clear treatment plan.

Radiotherapy, hormone treatment, chemotherapy, or targeted treatment may be discussed when the biopsy shows features that could respond to them. These decisions depend on the tumour findings rather than the skin appearance alone.

Arrange assessment with a breast specialist if you have persistent nipple scaling, redness, crusting, or discharge. Bring a list of medicines and previous breast imaging. Ask whether you need a skin or breast biopsy, diagnostic mammography, ultrasound, or other imaging before treatment is selected.

After surgery, follow wound-care instructions and report increasing redness, swelling, fever, or fluid from the wound. Discuss reconstruction, recovery, and any recommended treatment after the pathology report is available.

Seek prompt medical review for a new nipple change that does not settle, especially bleeding, one-sided discharge, a retracted nipple, or a new breast lump. These signs can have several causes, but they need examination and should not be diagnosed from appearance alone. Seek urgent help for heavy bleeding, severe breathlessness, fainting, or rapidly worsening illness after treatment.

Ask: Is the disease limited to the nipple and areola? Would lumpectomy or mastectomy be more appropriate for my imaging and biopsy results? Will lymph nodes be assessed? Could radiotherapy or drug treatment be useful? What changes should I report during recovery?