What are the symptoms of Paget disease of the breast?

The skin may look dry, irritated, or eczema-like, and the change may begin on the nipple before extending onto the darker skin around it. A nipple may become tender, pulled inward, or unusually flattened. Discharge can be clear, yellowish, or blood-stained. Some people also notice a breast lump, although a lump is not required for Paget disease.

These findings can also occur with non-cancerous skin conditions or infection. The pattern, persistence, and examination findings help a clinician decide whether breast imaging or a small skin biopsy is needed.

Arrange a clinical breast assessment for a new nipple or areola change that does not settle, especially when it affects one breast. Avoid repeatedly scratching the area or applying steroid, antifungal, or antibiotic cream without advice, because treatment can alter the appearance without explaining the cause.

Write down when the change began, whether it is spreading, and whether there is discharge or a lump. Bring this information to the appointment. If testing confirms Paget disease, treatment may involve surgery such as lumpectomy or mastectomy, depending on the area involved and any underlying breast cancer.

Seek prompt medical advice for persistent nipple scaling, crusting, bleeding, a new inward-pointing nipple, or spontaneous discharge. Seek urgent care for heavy bleeding, rapidly increasing swelling, severe pain, fever, or redness spreading across the breast, because these features can signal infection or another problem needing quick treatment.

Ask whether the skin change needs imaging or biopsy, what other causes have been considered, and how the nipple and breast will be examined. You can also ask which treatment would preserve the breast when possible and what recovery may involve.