Is there a change in the skin on your nipple? Let's learn about Paget's Disease of the Breast

Have you noticed a little redness, itching, or peeling on your nipples lately? You may think it's just a common skin condition, like eczema. It may even go away without treatment. But don't just ignore it as a minor issue, we're talking about a rare condition called breast cancer that you should definitely pay attention to.

Simply put, what is Paget's disease of the breast?

Paget's Disease of the Breast is a very rare type of cancer that occurs in the skin around your nipple. It accounts for between 1% and 4% of all breast cancers. This is when cancer cells grow on the surface of the skin of the nipple.

Importantly, many people with Paget's disease (over 90%) also have another type of cancer that has started in the same breast. It could be ductal carcinoma in situ (DCIS) , or invasive breast cancer, which has spread into the breast tissue. This means that this visible sign on the skin may actually be a sign of a bigger problem inside.

Who is most at risk of developing this disease?

Although anyone can develop breast cancer, certain factors can increase the risk. Let's take a look at what they are.

• Age: The risk increases gradually with age, especially after the age of 50. The average age of diagnosis is around 57 years.
• Gender: Women are much more likely to develop this disease than men.
• Family history: If your mother, sister, or daughter has had breast cancer, you are also at slightly higher risk.
• Genetic Mutations: Some people may inherit genetic mutations such as `(BRCA1)` and `(BRCA2)` that increase the risk of breast cancer.
• Excess body weight: Being overweight, especially after menopause, is also a risk factor.
• Alcohol use: Excessive alcohol consumption increases the risk of breast cancer.
• Dense Breasts: If you have a lot of glandular tissue in your breasts (this can be detected by a mammogram), that also increases your risk.
• Hormone therapy: Taking estrogen-containing hormone therapy for a long time after menopause may increase the risk.
• Radiation therapy: If you received radiation therapy to the chest area for any reason during childhood or adolescence, you are at an increased risk of developing breast cancer later in life.

What are the symptoms of Paget's disease? How do you recognize it?

The symptoms of this disease are very subtle at first. That's why many people ignore it. But it's very important to be aware of these symptoms.

Let's look at this table to clearly identify these symptoms.

Most of the time, this disease starts in the nipple and spreads to the dark skin area (areola) around it.

Doctor, how do you diagnose this?

When you go to see a doctor with symptoms like this, he will first examine you carefully. Then, he will recommend several tests to definitively diagnose the disease.

The most important and essential test is a biopsy . This involves taking a small piece of tissue from the skin of the nipple and examining it under a microscope to see if it contains 'Paget cells'. This biopsy can be done in several ways:

• Surface biopsy: A small sample of cells is scraped from the surface of the skin.
• Shave biopsy: The top layer of skin is removed with a sharp instrument.
• Punch biopsy: A small circular piece of skin is taken with a circular instrument.
• Wedge biopsy: A small surgical procedure to remove a piece of tissue.

Because Paget's disease is often accompanied by other cancers within the breast, your doctor will order additional tests to look for those as well. These may include:

• Mammogram: An X-ray examination of the breast.
• Breast Ultrasound: A test that uses sound waves to create a picture of the inside of the breast.
• Breast MRI Scan: A test that provides a very clear, detailed picture of the breast.

What are the treatments for this?

The treatment method is determined by the stage of your disease. That is, the doctor will choose the best treatment based on factors such as whether you have only Paget's disease, or whether there is other cancer within the breast, and whether it has spread.

How can you protect yourself from these types of cancers?

Although there is no way to 100% prevent cancer, we can reduce our risk by changing our lifestyle.

• Maintain a healthy weight.
• Exercise regularly.
• Limit alcohol consumption.
• Some studies have shown that breastfeeding children also reduces the risk of breast cancer.

If you have one or more risk factors for breast cancer, it is very important to talk to your doctor about it and get advice about things like regular screenings.

Breast cancer, Paget's disease, nipple itching, breast health, cancer symptoms, Paget's Disease of the Breast Sinhala, breast cancer symptoms