How is Paget's disease of the nipple diagnosed?

Most women notice Paget's disease of the nipple themselves since it starts with:

• Persistent crustiness, scaling and redness of the nipple
• The nipple may itch or burn
• There may be oozing or bleeding from the nipple area

This disease may look like eczema of the nipple at first. Eczema should respond to simple treatment with corticosteroid creams. If a rash on the nipple does not disappear with such treatment, then Paget’s disease is suspected. In an older woman who goes to the doctor with a nipple rash, Paget’s disease should be thought of without waiting to see if the rash responds to steroid creams.

If Paget’s disease is suspected, then the next step is often a mammogram to see if there is any definite area of cancer within the breast. However, if nothing is found, this is no reason to assume that further cancer is not present.

A biopsy of the nipple tissue will provide a definite diagnosis. If a lump or other suspicious area of the breast was found on mammogram, then this area will also be biopsied.