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Paget's of nipple and other areas of breast

Breast Cancer | Last Active: Mar 7 10:11am | Replies (23)

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I am a new member (@ahs7755) and I was recently diagnosed with Paget’s Breast Cancer. The diagnosis was made from evaluation of a skin shaving from the nipple of my right breast. After I received the diagnosis I felt a lump in that same breast. Because the biopsy was done by my dermatologist, the diagnosis of Paget’s was available when I saw the surgeon. At the first meeting the surgeon said that the best course of action was a mastectomy. The surgeon indicated that a lumpectomy was another option but that it would result in a donut shaped breast that would not be aesthetically pleasing. Additionally, the surgeon said that further biopsy of the lump or information regarding the stage or infiltration of the cancer would not change the recommendation. The additional testing would be done on the breast tissue and lump following the mastectomy. Is this the standard of care for Paget’s or would additional information about the cancer be important before having a mastectomy? I had an MRI today and expect additional information will come from that. Additionally, I am scheduled to see the Medical Oncologist 4/11 and the Radiation Oncologist 4/13.

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Replies to "I am a new member (@Ahs7755) and I was recently diagnosed with Paget’s Breast Cancer. The..."

Welcome, @ahs7755. According to Mayo Clinic:
"If you have Paget's disease of the breast, you will likely need surgery. The type of surgery depends on the condition of the skin around your nipple and how advanced the underlying cancer is." Read more here: https://www.mayoclinic.org/diseases-conditions/pagets-disease-of-the-breast/diagnosis-treatment/drc-20351084

I moved your question about treatment options for Paget's disease of the breast to this exisiting discussion:
- Paget's of nipple and other areas of breast https://connect.mayoclinic.org/discussion/pagets-disease-of-the-breast/

I did this so you can read the previous posts and connect easily with members like @mittd @sequoiatree and @debraw to hear about their treatment decisions.

Are you in favor of having a mastectomy or would you like to explore the options of a lumpectomy?

After my first nipple biopsy confirmed pagets, I was scheduled for biopsy on the other two growths in same breast. From what I understand, Pagets is a type if skin cancer in nipple. In my case further biopsy of other breast growths determined a separate diganosis of DCIS. Invasive ductal carsinoma of breast. It is high grade w/necrosis in one of the growths. The biopsy also provided estrogen levels in which I showed a low positive antibody. This might determine the type of chemo strategies and if they need to check my ovaries for potential issues. I have MRI with contrast of both breasts in interim to see if any smaller lesions or missed areas in either breast are present. My doctor ordered a genetic test which also can determine type of chemo. Hope this helps @ahs7755 It can be confusing but my Dr. has been on a fast track with biopsies, diagnosing and further testing prior to surgury (greatful for) and I'm learning as much as I can about testing, diagnosis and procedures and asking questions. Seek second opinion if needed is also an option although I have confidence in the science with tests and in my Dr. To determine the course of TX. I know I'm looking at surgury but good to know all the info before proceeding. It's been only three weeks so a big learning curve.