Paget's Disease – The Not So Common Breast Cancer

Most women, when giving themselves a self-examination of the breast (while looking for breast cancer), do so by looking for signs of lumps (solid masses), or uncomfortable areas within the breast. That is to say – "within the main formation of the breast" (the bubby). However, some breast cancer signs and symptoms may also look considerably like common skin complains, such as:

1. Eczema – which is a chronic inflammatory skin condition (the skin becomes dry, has red patches, and usually itches).

2. Psoriasis – is where the skin has raised patches (usually red in color), and with thick silvery scales.

Paget's Disease – on the other hand, is also like a red rash that resembles both eczema and psoriasis, but affects just the epidermis (the surface of the skin) of the nipple, and the areola (the circle of dark skin formed around the nipple ) with malignant cancer cells (formed singularly, or in small groups).

However, eczema seldom affects the nipple, and other common skin conditions usually affect both breasts and not just one (Paget's disease rarely affects both breasts at the same time). For this reason, Paget's disease can be difficult to diagnose (a patient may be referred to a specialist for diagnosis).

Many common skin rashes are benign (non-cancerous) conditions; however, that is not the case with Paget's disease which is malignant (cancerous). The good news is that the disease is very rare (affecting only 1% – 4% of women who are diagnosed with breast cancer [the bad news is that Paget's disease also may indicate that a breast tumor is present]).

It is common for around 50% of women who suffer from Paget's disease to also suffer from a breast tumor (stage I – III ductal carcinoma, or invasive breast cancer) on the same-side. Sometimes more than one tumor may exist in a patient's breast. Although Paget's disease resembles both eczema and psoriasis, an inverted nipple (pulled inwards), or a nipple discharge may also be present.

Diagnosis may include: a mammogram (screening or diagnostic), ultrasound scan, or a biopsy (nipple scrape biopsy, punch biopsy, core biopsy, or image guided biopsy), followed by surgery (usually recommended first option [lymph node sample biopsy surgery, or lymph node clearance surgery]). Further additional treatment may also be needed, such as: chemotherapy, radiotherapy, hormone (endocrine) therapy, or targeted therapies.

It is advised that any noticeable difference to the breast should be checked-out as soon a possible, as Paget's disease is a very good example of how a deadly form of cancer can sometimes be mistaken for something that is more common and often harmless.

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