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Paget’s Disease Breast Appearance

The skin changes seen in Paget’s disease of the breast are not specific and can be confused with many other common, more benign skin diseases. The typical lesions are pink to red, irregularly shaped, scaly patches or elevated plaques on or near the nipple and areola.

These patches and plaques may extend centrifugally around the areola onto the breast skin. Most cases are unilateral, but bilateral lesions can occur. Over time, months or even years, the patches become more indurated, and nodular. Eventually, the nipple and areola may become distorted, retracted, indented, ulcerative and destroyed. An underlying breast mass can be palpated in approximately 50% of cases.

The second breast should also be examined carefully as the risk of intraductal breast cancer is increased in that breast. Also, one should examine regional lymph nodes.