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Treatments and drugs

By Mayo Clinic staff

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Images of simple and modified radical mastectomy Simple mastectomy and modified radical mastectomy

Living With Cancer

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If you have Paget's disease of the breast, you will likely need surgery. The type of surgery 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.

Coping and support Tests and diagnosis
References
  1. AskMayoExpert. How is Paget disease of the breast treated? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
  2. AskMayoExpert. What are the clinical findings of Paget disease of the breast? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
  3. AskMayoExpert. Paget disease of the breast: Key facts. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
  4. Paget disease of the breast. National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/Sites-Types/paget-breast. Accessed Feb. 11, 2013.
  5. Papadakis MA, et al. Current Medical Diagnosis & Treatment 2013. 52nd ed. New York, N.Y.: The McGraw-Hill Companies; 2013. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=1. Accessed Feb. 10, 2013.
  6. Karakas C. Paget's disease of the breast. Journal of Carcinogenesis. 2011;10:31.
  7. Goldsmith LA, et al., eds. Fitzpatrick's Dermatology in General Medicine. 8th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=740. Accessed Feb. 10, 2013.
  8. Dominici LS, et al. Current surgical approach to Paget's disease. American Journal of Surgery. 2012;204:18.
  9. Breast cancer risk in American women fact sheet. National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/detection/probability-breast-cancer.  Accessed Feb. 10, 2013.
  10. What is breast cancer? American Cancer Society. http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-what-is-breast-cancer. Accessed Feb. 10, 2013.
  11. How is breast cancer treated? American Cancer Society. http://www.cancer.org/cancer/breastcancer/overviewguide/breast-cancer-overview-treating-surgery. Accessed Feb. 11, 2013.
  12. Can breast cancer be prevented? American Cancer Society. http://www.cancer.org/cancer/breastcancer/overviewguide/breast-cancer-overview-prevention. Accessed Feb. 11, 2013.
  13. Coping with cancer in everyday life. American Cancer Society. http://www.cancer.org/treatment/treatmentsandsideeffects/emotionalsideeffects/copingwithcancerineverydaylife/index. Accessed Feb. 21, 2013.
  14. After a breast cancer diagnosis: Questions to ask your doctor. Cancercare. http://www.cancercare.org/publications/46-after_a_breast_cancer_diagnosis_questions_to_ask_your_doctor. Accessed Feb. 25, 2013.
  15. Breast cancer: Coping with your changing feelings. Cancercare. http://www.cancercare.org/publications/88-breast_cancer_coping_with_your_changing_feelings. Accessed Feb. 25, 2013.
DS00771 March 27, 2013

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