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Paget’s disease of the breast is fortunately a very uncommon diagnosis for patients. Usually what happens is a patient will be seen by their surgeon or breast surgeon, and they have a little change going on in the nipple or the areola complex. Usually it’s some thickening of the skin, some skin on the skin, or even some discharge. Fortunately, most of the time that is a dermatitis or some benign physiological process causing the nipple discharge. Those patients will usually respond to medical treatment, but in some of those patients, that process will persist. There’s a disease process like we mentioned called Paget’s disease. Basically it’s an underlying DCIS or ductal carcinoma in situ, or an invasive component that manifests itself through the N ducts, through the nipple, and has manifested itself in a continuous fashion, which means spread around the skin of the nipple of the areola complex. When you have a disease process like that that persists, those patients will need either a shave biopsy, a skin biopsy, which we call a punch biopsy where we’re taking a punch or a little cylinder of that skin, or even a wedge biopsy where we take a sampling of that skin, so we can get an accurate diagnosis of that tissue. Once you’ve been diagnosed with Paget’s disease of the breast, whether it’s a noninvasive cancer, which we call DCIS or invasive cancer, it’s treated the same way as standard breast cancer. It just manifests itself in a different fashion.
