When something changes on the nipple or areola, it can feel confusing or easy to dismiss as simple irritation. At Learn Look Locate, we want every woman—and every clinician—to know that sometimes these subtle changes are telling us something important. One of the rare conditions that can hide behind what looks like ordinary skin irritation is Paget’s disease of the breast, a rare form of breast cancer that is often misdiagnosed or overlooked.
This warm and educational guide is here to bring clarity, confidence, and compassion. With expert insights from Dr. Yara Robertson, Surgical Oncologist and Learn Look Locate Medical Advisor, and the lived experience of survivor Laura Parker, this page helps you understand the early signs and know when to ask for more.
Paget’s disease of the breast is a rare type of breast cancer that begins in the nipple ducts and spreads outward to the skin of the nipple and areola. Because it often resembles eczema, dermatitis, or a simple rash, many women receive treatment for a skin condition first—sometimes for months or years—before the correct diagnosis is made.
Early recognition is essential, as Paget’s disease is often associated with an underlying cancer such as ductal carcinoma in situ (DCIS) or invasive ductal carcinoma (IDC).
Your visual comparison chart is an essential educational tool because the nipple is not a common place for eczema. Paget’s disease, however, begins exactly there.
Here is a gentle and clear breakdown:
Paget’s Disease
Eczema Dermatitis
If irritation begins on the nipple itself, a breast specialist should evaluate it promptly.
Because Paget’s disease looks like eczema, many women are given topical creams or told to “wait and watch.”
Dr. Yara Robertson reminds us:
“Any persistent nipple change deserves further evaluation. When symptoms don’t improve with standard skincare or steroid creams, that should be a red flag.”
Mammograms do not always show Paget’s disease, especially when the underlying cancer is small or when the patient has dense breasts. This is why a biopsy of the nipple or areola is often necessary for diagnosis.
People often describe:
Even if symptoms come and go, they deserve attention.
At the age of 34, Laura Parker noticed changes on her nipple that were initially dismissed as a skin condition. Despite creams and reassurance, her symptoms continued. Laura trusted her instincts and pushed for answers.
Her persistence led to a biopsy that finally revealed Paget’s disease of the breast, along with underlying DCIS.
Her story—a cornerstone of Learn Look Locate—reminds us:
You know your body. If something feels wrong, keep asking until someone listens.
Diagnosis may include:
If symptoms do not resolve, a biopsy is essential.
To learn more about imaging:
Treatment depends on the presence of underlying cancer. Options may include:
Your care team will personalize treatment based on imaging and pathology.
Seek medical attention if:
You deserve answers and clarity.
Q1. Is Paget’s disease of the breast cancer?
A: Yes. It is a rare type of breast cancer involving the nipple and often linked to DCIS or invasive cancer. Early diagnosis is key.
Q2. What are the first signs of Paget’s disease?
A: Look for:
• Redness
• Scaling or flaking
• Itching or burning
Nipple flattening or inversion
If symptoms last more than two weeks, seek evaluation.
Q3. How is Paget’s disease different from eczema?
A: Paget’s disease starts on the nipple and affects one breast. Eczema usually starts on the areola and can involve both breasts. Paget’s disease does not fully resolve with creams.
Q4. Can Paget’s disease come and go?
A: Yes. Symptoms may briefly improve with creams, but they return. This pattern often delays diagnosis.
Q5. Does Paget’s disease always cause a lump?
A: No. Many people never feel a lump. Skin changes may be the only sign.
Q6. Does Paget’s disease show up on a mammogram?
A: Sometimes. Imaging can be normal, especially in dense breasts. A biopsy is the most reliable way to confirm the diagnosis.
Q7. How is Paget’s disease diagnosed?
A: A breast exam, imaging, and a nipple or areola biopsy. The biopsy provides the definitive diagnosis.
Q8. What are the treatment options?
A: Treatment may include surgery, radiation, lymph node evaluation, and additional therapy if invasive cancer is present.
Q9. Can younger women get Paget’s disease?
A: Yes. Although more common after age 50, younger women can be affected too.
Q10. Should I see a dermatologist or a breast surgeon?
A: If symptoms begin on the nipple or persist, it is best to see a breast surgeon. They can order imaging and a biopsy if needed.
Q11. Does Paget’s disease always mean underlying cancer?
A: Most cases are linked to DCIS or invasive cancer, but not all. A full diagnostic workup clarifies this.
Q12. Can men get Paget’s disease?
A: Yes, though rare. Any persistent nipple change in men should be checked.
Q13. What should I do if I suspect Paget’s disease?
A: Trust your instincts. If symptoms don’t get better, schedule an appointment with a breast specialist. Persistent nipple changes deserve attention.
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