What are the treatment options for paget disease of the breast?

Paget disease affects the nipple and areola and may occur with an underlying area of breast cancer. The team uses examination, breast imaging and tissue results to understand the extent of disease. Lumpectomy removes the nipple-areola area and the affected breast tissue while preserving much of the breast; radiotherapy may be discussed afterward when appropriate.

Mastectomy removes the breast and may be recommended when disease is extensive, involves several areas, or breast-conserving surgery would not provide a suitable result. Lymph-node assessment and other treatments may be considered when an underlying invasive cancer or other high-risk feature is found.

Ask whether the nipple changes are isolated or linked with cancer elsewhere in the breast, and what the imaging and biopsy show. Discuss the expected breast shape, sensation, scars, recovery, reconstruction and whether radiotherapy or medicines may follow surgery.

Before surgery, share your medicines and health conditions with the team. Afterward, follow wound and drain instructions, protect the incision as advised, and mention increasing redness, fluid, swelling or arm movement problems.

Arrange prompt assessment for persistent nipple crusting, discharge, bleeding, inversion, a new breast lump, skin thickening or a change that does not settle. After treatment, seek urgent advice for fever, rapidly increasing breast swelling, severe pain, wound separation, heavy bleeding or sudden breathlessness.

Is the disease limited to the nipple area? Would lumpectomy or mastectomy give the safer treatment plan? Will lymph nodes be assessed? Could I need radiotherapy or medicines afterward? What reconstruction and recovery choices are available?