Epidemiology | What is Paget’s disease?

Epidemiology

It settles in or around the nipple. 0.5 to 5% of all tissue changes in the breast are Paget’s cancer. Usually the affected patients are between 40 and 50 years old, but rarely the cancer form Paget’s disease can also manifest itself in patients aged 20 years. The average age for the first manifestation of Paget’s disease is currently 62 years for women and 69 years for men.

Paget’s disease of the nipple

Paget’s disease of the nipple is a rare cancer that can also affect other parts of the body. Almost only women fall ill with this cancer, which often remains undetected for a long time. In its early stages, the cancer resembles an eczema of the nipple and is therefore often treated incorrectly with ointments and creams.

Like other cancers, it is not palpable as a lump, nor does it show any other symptoms that would initially make one think of cancer. Itching, reddening of the skin and eczematous-scarring skin changes on the nipple are the first symptoms of Paget’s disease. However, if there is no improvement through dermatological treatment, Paget’s disease is usually suspected.

Later, bloody secretions and retraction of the affected nipple occur. The diagnosis can be confirmed by taking a sample. Under the microscope large roundish cells with altered cell nuclei can then be seen.

The therapy of choice is surgical removal of the cancer, if possible with preservation of the breast. In case of lymph node infestation, affected lymph nodes must also be removed. Following the operation, the tissue is irradiated to prevent recurrence.

In advanced stages, these therapeutic options are not sufficient and chemotherapeutic therapy approaches must be considered. Treatment of Paget’s disease is individualized, depending on the nature of the tumor, the degree of metastasis and the individual circumstances of the patient. A curative therapeutic approach is possible in early stages of the disease. Unusual skin rashes on the nipple, retractions or bloody secretions should therefore always make you suspicious and lead to a visit to the gynecologist.