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Treatments and drugs
By Mayo Clinic staff
Paget's disease of the breast usually requires surgery. Which type of surgery you need depends on the condition of the skin around your nipple and how advanced the underlying cancer is.
Surgical options include:
- Simple mastectomy. This procedure involves removing your entire breast, but not the lymph nodes in your armpit (axillary lymph nodes). Simple mastectomy might be recommended in cases in which an underlying breast cancer exists but hasn't spread to the lymph nodes.
- Lumpectomy. Breast-conserving surgery (lumpectomy) involves removing only the diseased portion of your breast. Your surgeon removes your nipple and areola along with a wedge- or cone-shaped section of your breast. The surgeon focuses on removing as little breast tissue as possible, while ensuring that the tissue removed includes an outer margin free of cancer cells so that only healthy cells remain. Lumpectomy to treat Paget's disease of the breast requires follow-up radiation therapy. Lumpectomy wouldn't be recommended if you can't have radiation therapy for some reason. Most women have nipple reconstruction after their treatment.
Adjuvant therapy
After your operation, your doctor may recommend additional treatment (adjuvant therapy) with anti-cancer drugs (chemotherapy), radiation therapy or hormone therapy to prevent a recurrence of breast cancer. Your specific treatment will depend on the extent of the cancer and whether your tumor tests positive for certain characteristics, such as having estrogen or progesterone receptors.
- Sabel MS, et al. Paget disease of the breast. http://www.uptodate.com/home/index.html. Accessed Aug. 4, 2010.
- Paget disease of the nipple: Questions and answers. National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/Sites-Types/pagets-breast. Accessed Aug. 4, 2010.
- Abeloff MD, et al. Cancer of the breast. In: Abeloff MD, et al. Clinical Oncology. 4th ed. Philadelphia, Pa.: Elsevier Churchill Livingstone; 2008. http://www.mdconsult.com/das/book/body/100861143-2/0/1241/895.html?tocnode=51163917&fromURL=895.html#4-u1.0-B0-443-06629-9..50099-3--cesec126_4227. Accessed Aug. 4, 2010.
- Nicholson BT, et al. Nipple-areolar complex: normal anatomy and benign and malignant processes. RadioGraphics. 2009;29:509.
- Estimating breast cancer risk: Questions and answers. National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/estimating-breast-cancer-risk. Accessed July 30, 2008.
- What are the risk factors for breast cancer? American Cancer Society. http://www.cancer.org/docroot/CRI/content/CRI_2_4_2X_What_are_the_risk_factors_for_breast_cancer_5.asp?sitearea. Accessed Aug. 5, 2010.
- Morrogh M, et al. MRI identifies otherwise occult disease in select patients with Paget disease of the nipple. Journal of the American College of Surgeons. 2008;206:316.
- Caliskan M, et al. Paget's disease of the breast: The experience of the European institute of oncology and review of the literature. Breast Cancer Research and Treatment. http://www.springerlink.com/content/6270v27346461v08/. Accessed Aug. 5, 2010.
- Can breast cancer be prevented? American Cancer Society. http://www.cancer.org/Cancer/BreastCancer/OverviewGuide/breast-cancer-overview-prevention. Accessed Aug. 5, 2010.
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