In plain words
Paget disease of the nipple is a rare change in the skin of the nipple and the area around it. It looks like a red, scaly, or crusted patch. It does not heal with usual nipple care. Most nipple problems in breastfeeding are common and heal. Paget disease is uncommon, and it needs a clinician to look at it. A biopsy is the way to confirm it. The condition is linked to an underlying breast cancer in many cases. Mothers may be asked about the patch at a visit if it has not improved over several days. Most in the early weeks are not this condition, and the signs overlap with other causes.
The deeper version
Mammary Paget disease is an intraepidermal adenocarcinoma of the nipple-areolar complex, typically unilateral, presenting as eczematous change, erythema, scale, and erosion that do not respond to topical therapy. An underlying invasive or in situ breast carcinoma is found in most cases. The differential in the lactating breast includes mechanical trauma, bacterial and candidal infection, dermatitis, , and herpes simplex. The Academy of Breastfeeding Medicine's protocol on nipple pain (Protocol #26) notes that persistent, unilateral, non-healing eczematous change warrants referral for biopsy. Diagnosis requires histopathology, and delay in biopsy is the main clinical concern.
Where it comes up
- Nipple pain, cracks, and healingPostpartum: Your Body
- Thrush and other nipple infectionsPostpartum: Your Body
- Getting a deep latchFeeding Your Baby
- Clogged ducts and mastitisPostpartum: Your Body
What mothers here say about Paget disease of the nipple
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Sources
- Academy of Breastfeeding Medicine — Clinical Protocol #26: Managing nipple pain and damage
- Mayo Clinic — Paget disease of the nipple: symptoms and causes