What does nipple discharge feel like with Paget disease of the breast?

The discharge itself may feel like dampness or a drop on the nipple rather than a distinct internal sensation. It can be yellowish, watery, or blood-stained. Paget disease may also cause itching, burning, redness, scaling, crusting, or a sore area on the nipple or darker skin around it. The nipple may become flatter or change shape, and a breast lump can occur. These changes can resemble eczema or irritation, so appearance and sensation alone cannot establish the diagnosis. Paget disease is uncommon, but nipple changes that persist need review.

Make an appointment promptly if discharge is new or continues, especially when it comes from one side or appears without squeezing. Do not apply repeated irritants or keep rubbing the area to remove crusting. Note when symptoms began, whether the skin change is confined to the nipple, and whether there is a lump or pain. A clinician may examine the nipple and breast, arrange imaging, or recommend a small skin or tissue sample if the appearance needs clarification.

Seek prompt medical review for bloody discharge, a persistent crust or sore, nipple inversion, a new lump, or redness and swelling that does not settle. Fever, rapidly increasing warmth, or severe breast pain may indicate an infection and also warrants timely care. Do not wait for discharge to become heavy; a small amount alongside a persistent nipple change still deserves assessment.

Could this be eczema, infection, or a condition affecting the nipple? Do I need breast imaging or a biopsy of the skin? What changes should prompt me to return sooner?