I hadn't heard of secondary Paget's til reading above. I wonder if that is what I have, as the gyno-oncologist said it seems to be related to having had breast cancer. And now metastatic breast cancer after 20 years. Secondary is non-invasive?? At any rate, he says mine isn't invasive or aggressive. So, no surgery or imiquimod. Thank God, as I have enough dealing with the cancer again.