What do breast skin changes feel like with Paget disease of the breast?

The nipple or darker skin around it may become dry, flaky, thickened, crusted, or sensitive. The change can resemble eczema, but Paget disease often begins at the nipple and may continue despite ordinary skin care. Nipple discharge, a newly pulled-in nipple, or a lump deeper in the breast can also occur. Breast Skin Changes is a very common presentation of Paget Disease of the Breast; this does not mean every breast skin change is Paget disease.

A clinician may examine both breasts and arrange imaging. A small skin or nipple sample may be needed to identify abnormal cells and distinguish Paget disease from dermatitis or another cause.

Arrange a breast assessment for a new nipple or areola change, especially when it affects one side, persists, recurs, or comes with discharge or a lump. Keep the area gently clean and avoid scratching or applying new medicated creams until it has been assessed, because treatment can alter the appearance.

Seek prompt medical advice for a persistent scaly or raw nipple, bloody discharge, a new inward-pointing nipple, skin thickening or puckering, or a breast lump. Urgent care is appropriate for rapidly spreading redness with fever, severe pain, or feeling acutely unwell.

Ask whether the change needs imaging or a biopsy, whether a sample would come from the nipple skin or breast tissue, and what symptoms should prompt an earlier review.