When to worry about breast skin changes with Paget disease

Paget Disease of the Breast often affects the nipple and the darker skin around it. Changes can resemble eczema, with redness, scaling, crusting, burning, itching, soreness, or a weeping surface. Most people with Paget Disease of the Breast notice breast skin changes.

A nipple that becomes newly flattened or pulled inward, discharge from one nipple, a lump behind the nipple, or skin that remains irritated deserves examination. Breast Skin Changes alone cannot establish the cause, and several non-cancerous conditions can look similar.

Do not keep treating a persistent nipple rash with creams without arranging a review. Note when the change began, whether it is on one side, and whether there is discharge, bleeding, pain, or a lump. Avoid picking crusted skin and bring a list of products or medicines used on the area.

A clinician may examine the nipple, breast, and nearby lymph nodes. Depending on the findings, assessment can include breast imaging and a small skin sample. The sample helps identify the cause when appearance alone is unclear.

Arrange prompt clinical assessment for a nipple or areola change that persists, returns after treatment, bleeds, forms a crust, or produces one-sided discharge. Seek urgent help for rapidly increasing swelling, severe pain, heavy bleeding, or feeling seriously unwell.

Do not wait for a lump before seeking advice. Early review is appropriate for a new one-sided change, even when it is mild or resembles dermatitis. Take photographs only if useful for showing progression; they do not replace an examination.

Ask: Does this involve the nipple or the surrounding breast tissue? Could a skin sample help? Do I need imaging? What should I use for irritation while the cause is being checked?