Paget's disease of the breast

Paget's disease of the breast is a type of cancer that outwardly may have the appearance of eczema, with skin changes involving the nipple of the breast. The condition is an uncommon disease accounting for 1 to 4.3% of all breast cancers and was first described by Sir James Paget in 1874. The condition in itself often appears innocuous, limited to a surface appearance and it is sometimes dismissed, although actually indicative of underlying breast cancer. Immunohistochemistry of Paget cells and underlying breast cancer show a more aggressive, HER2-enriched, molecular subtype of breast cancer. Paget's disease of the breast can affect the nipple and areola. Symptoms typically only affect one breast. Symptoms may include: Skin. The first symptom is usually an eczema-like rash. The skin of the nipple and areola may be red, itchy and inflamed. After a period of time, the skin may become flaky or scaly. Discharge. A discharge, which may be straw-colored or bloody, may ooze from the area. Sensation. Some women have a burning sensation. These symptoms usually occur in more advanced stages, when serious destruction of the skin often prompts the patient to consult. Lumps or masses in the breast occur in 50% of the patients. In more advanced stages, the disease may cause tingling, increased sensitivity and pain. Nipple changes. The nipple may become inverted. Breast changes. There may or may not be a lump in the breast, and there may be redness, oozing and crusting, and a sore that does not heal. The symptoms usually affect the nipple and then spread to the areola and then the breast. It is common for the symptoms to wax and wane. Most women do not visit the doctor because they assume Paget's disease to be minor contact dermatitis or eczema. A lump or skin irritation that does not seem to heal for over a month indicates that attention by a specialist is needed. Paget's disease of the breast is characterised by Paget cells. Paget cells are large cells with clear cytoplasm (clear halo) and eccentric, hyperchromic nuclei found throughout the epidermis.