What Leads To Paget’s Disease Of The Breast & Can It Be Cured?

Paget’s disease of the nipple or breast is a rare type of breast cancer, where cancer cells accumulate across the nipple. The problem often affects the nipple ducts and spreads to areola and nipple surface.(1)

Paget’s disease of the breast characterizes inflammatory and eczema types of changes in the nipple. The disease extends to areola i.e. a dark and circular skin region across the nipple.(2)

According to a widely accepted theory, cancer cells from the tumors within the breast travel from milk ducts to reach to the areola and nipple.(3)

What Leads To Paget’s Disease Of The Breast?

Until now, doctors have not identified the exact cause associated with Paget’s disease of the breast. However, one theory says that such patients already have breast cancers and few of the cancerous cells migrate from milk ducts to the nipple surface. Another valid reason for Paget’s disease of the breast is that the nipple’s skin cells convert into cancerous cells spontaneously. In a few of the cases related to Paget’s disease of the breast, patients do not have any underlying breast cancer and if they have breast tumors, they do not have any link with the nipple’s disease.

Doctors have revealed certain risk factors related to Paget’s disease of the breast and they are almost similar as you find in any other type of breast cancer. These include the following-

  • Age of individuals, as the risk will increase with time
  • Previous personal history related to breast abnormalities or breast cancer
  • If you have a relative suffering from breast cancer
  • Patients, who have relatively dense breast tissues
  • Obesity or excessive weight
  • HRT i.e. hormone replacement therapy
  • Excessive consumption of alcohol.(4)

Can Paget’s Disease Of The Breast Be Cured?

Whether Paget’s disease of the breast cures completely or not depends on individual patients. However, doctors mainly apply the following treatments for the patients.
If you are suffering from Paget’s disease of the breast, you have to undergo surgery. However, the specific type of surgery depends solely on the skin condition across the nipple and the advancement of your underlying cancer. Common options related to breast cancer or Paget’s disease surgery are as follows-

Simple Mastectomy: In a simple mastectomy procedure, doctors remove your breast completely but leave the lymph nodes belonging to your armpit i.e. auxiliary lymph nodes. This type of surgery is recommendable when you have underlying breast cancer but it never spreads to lymph nodes.

Lumpectomy: Lumpectomy i.e. breast-conserving surgery involves the removal of only diseased portion of the patients’ breast. In this case, the surgeon also removes the areola and nipple along with a cone or wedge-shaped breast section. In other words, your surgeon will focus on removing only a small part of the breast tissue as possible.

Your doctor also makes sure that the removal of the tissue involves an outer margin that remains free from cancerous cells so that the patients have remaining healthy cells. Lumpectomy associated with the treatment of Paget’s disease of the breast needs regular follow-up in the form of radiation therapy and many women even undergo nipple reconstruction after their treatment.

Additional Therapies/Treatments After Surgery

Once you undergo the surgery for Paget’s disease of the breast, your doctor will recommend a few of the additional therapies/treatments to avoid the occurrence of breast cancer again. These include adjuvant therapy combined with radiation therapy, anti-cancer drugs i.e. chemotherapy and hormone therapy, and similar others. However, your specific treatment or therapy depends on the extent of your cancer and certain characteristics of your tumor, like the presence of progesterone receptors and estrogen.(5)

Conclusion

To conclude, we should say that Paget’s disease of the breast takes place because of the migration of cancerous cells from milk ducts towards the nipple surface. However, one can suffer from the problem, because of additional risk factors, as in the case of other types of nipple or breast cancers.

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