Paget disease of the nipple is a rare breast cancer that affects the skin of the nipple and often the darker skin around it. It can cause itching, burning, redness, scaling, crusting, or a bloody or yellow discharge, and the early symptoms of Paget disease of the nipple are sometimes mistaken for eczema. It usually affects adults over age 50, but not everyone will have the same experience. Paget disease of the nipple does not go away on its own, and treatment usually involves surgery and may also include radiation, hormone therapy, targeted therapy, or chemotherapy if an underlying breast cancer is found. The outlook depends on whether there is cancer deeper in the breast and how far it has spread, but earlier diagnosis often improves outcomes.
How many people live with Paget disease of the nipple?
Paget disease of the nipple is usually estimated from breast cancer totals rather than counted on its own: about 7.8 million women worldwide were alive within 5 years of a breast cancer diagnosis (WHO, 2024), and because Paget disease of the nipple makes up about 1% to 4% of breast cancers, depending on the study, that suggests roughly 78,000 to 312,000 people worldwide may be living with it, but this is an estimate, not a direct count. In the United States, more than 4 million women are living with a history of breast cancer (American Cancer Society, 2024), which suggests about 40,000 to 160,000 people may be living with Paget disease of the nipple here, again as an estimate rather than a direct count.
Overview
Paget disease of the nippleSymptoms
Paget disease of the nipple often causes itching, burning, or pain in the nipple area, with redness, scaling, or a rash that may look like eczema. Some also notice nipple flattening, discharge, or a lump in the breast.
Outlook and prognosis
With Paget disease of the nipple, outlook is often good when treated early, especially if cancer is limited to the nipple or nearby milk ducts. Prognosis depends mainly on whether there is a deeper breast tumor or involved lymph nodes.
Causes and risk factors
Paget disease of the nipple usually develops with an underlying breast cancer. Risk rises with older age, being female, certain inherited gene changes such as BRCA, and a family history of breast or ovarian cancer. Alcohol use and obesity after menopause may also raise risk.
Genetic influences
Genetics are not a major cause of Paget disease of the nipple in most people. It usually happens along with an underlying breast cancer rather than from a single inherited gene change. Family history can still matter for overall breast cancer risk.
Diagnosis
Paget disease of the nipple is diagnosed with a breast exam and skin biopsy. Imaging, such as a mammogram or ultrasound, often checks for an underlying breast cancer. Early diagnosis of Paget disease of the nipple matters.
Treatment and drugs
Paget disease of the nipple is usually treated with surgery, often to remove the nipple area and sometimes the breast tissue beneath it. Many also need radiation, and some receive medicines such as hormone therapy, targeted treatment, or chemotherapy.
Symptoms
A sore, itchy nipple that does not heal can be easy to brush off at first, especially if it seems like dry skin. Paget disease of the nipple often affects one nipple and the darker skin around it, and it may look like a rash that keeps coming back. You might notice small changes at first, but the area often becomes more irritated over time. Because the early symptoms of Paget disease of the nipple can resemble eczema or simple skin irritation, persistent changes should be checked by a healthcare professional.
Many people first notice ongoing itching, tingling, or a burning feeling in one nipple. Unlike brief irritation from clothing or soap, this discomfort often does not fully go away.
The skin on the nipple or areola may look red, flaky, or scaly. It can resemble eczema, but creams for dry skin may not clear it or the rash may quickly return.
The area can become crusted, thickened, or cracked. Some people with Paget disease of the nipple find that the skin feels raw and rubs painfully against clothing or a bra.
Fluid from the nipple may be clear, yellowish, or blood-stained. Even a small amount of discharge or spotting can be an important warning sign.
How people usually first notice Paget disease of the nipple?
Many people first notice Paget disease of the nipple when one nipple develops a persistent eczema-like change that does not clear up, often with redness, scaling, crusting, itching, burning, or unusual sensitivity. The first signs of Paget disease of the nipple may also include a flattened or turned-in nipple, yellow or bloody discharge, or a sore area on the nipple or darker skin around it that slowly worsens instead of healing. In many cases there is also a lump in the breast, but not always, which is why a stubborn rash on one nipple should be checked rather than treated as simple skin irritation.
Types of Paget disease of the nipple
Paget disease of the nipple can show up in a few different symptom patterns, and that is one reason it is sometimes mistaken for a skin rash at first. Symptoms don’t always look the same for everyone. Many people notice changes in the nipple and darker skin around it first, while others also have changes deeper in the breast. Early symptoms of Paget disease of the nipple are often mild, but symptoms that persist or keep coming back should be checked by a doctor.
Skin changes
The nipple or the darker skin around it may look red, flaky, crusted, or irritated. It can resemble eczema, but it usually does not fully settle with ordinary skin creams. Some may also notice burning, itching, or soreness.
Nipple discharge
Paget disease of the nipple can cause fluid to leak from the nipple, including clear fluid or fluid tinged with blood. This may happen on its own or after the area is rubbed or pressed.
Nipple shape change
The nipple may become flatter than usual or start to turn inward. For many, this change develops gradually and may happen along with scaling or tenderness.
Breast lump signs
Some people with Paget disease of the nipple also have a lump or thicker area in the breast tissue underneath or nearby. When this is present, symptoms may feel less like a skin problem alone and more like a breast change that needs urgent assessment.
Can I slow down the onset of symptoms?
No, there is no good evidence that lifestyle changes or medicines can meaningfully delay the start of Paget disease of the nipple. Healthy habits such as staying active, limiting alcohol, and keeping a healthy weight may lower the overall risk of some breast cancers, but they have not been shown to specifically delay or prevent this condition, and lowering risk is not the same as stopping it from happening. Regular breast screening and getting a new nipple rash, scaling, discharge, or skin change checked early can help find problems sooner, which can make treatment more effective even though it does not prevent the disease.
What genetics can tell you about symptoms
Genetics can sometimes help explain why Paget disease of the nipple appears in some families, but for most people, genetic testing does not clearly predict which symptoms will happen, how severe they will be, or exactly when they will start. Most symptoms, such as nipple itching, burning, scaling, crusting, discharge, or a flattened nipple, are mainly linked to the underlying breast cancer and how far it has developed rather than to a specific inherited gene change. In short, genetics may help estimate overall breast cancer risk in some people, but it usually cannot forecast the day-to-day symptom pattern of Paget disease of the nipple.
Causes and risk factors
Paget disease of the nipple usually happens when cancer cells from deeper breast ducts spread into the skin of the nipple and areola. The risk is higher in older adults, in women, and in people with a personal or family history of breast cancer. Inherited gene changes such as BRCA1 or BRCA2 can also raise the chance because they increase overall breast cancer risk. On top of genetics, everyday habits also matter. Drinking alcohol, carrying extra weight after menopause, getting little exercise, using combined hormone therapy for a long time, or having past chest radiation can increase risk factors for Paget disease of the nipple.
What are the most common causes or risk factors?
Paget disease of the nipple is usually caused by an underlying breast cancer, most often when cancer cells from the milk ducts spread into the skin of the nipple and the darker skin around it. The main risk factors are much like those for breast cancer overall, especially older age, being female, a personal or family history of breast cancer, and inherited gene changes such as BRCA1 or BRCA2 that strongly raise risk. Other well-known factors include prior radiation to the chest, drinking alcohol, obesity after menopause, and longer lifetime exposure to estrogen, the main female sex hormone.
Environmental and biological risk factors
Paget disease of the nipple is rare, but it is more likely in people who already have factors that raise breast cancer risk because it is usually linked to cancer in the breast ducts. Doctors often group risks into internal (biological) and external (environmental). Knowing the risk factors for Paget disease of the nipple can help you get ongoing nipple changes checked sooner.
Paget disease of the nipple is seen more often after age 50. Risk rises with age because breast cancers become more common over time.
Women are much more likely to develop Paget disease of the nipple than men. This mainly reflects the much higher rate of breast cancer in women.
A past breast cancer or certain abnormal cells found on a breast biopsy can raise later breast cancer risk. Because Paget disease of the nipple is often linked to an underlying breast cancer, these histories can also raise risk.
Having dense breast tissue can increase breast cancer risk. That may also make Paget disease of the nipple more likely, even though dense tissue itself does not directly cause nipple symptoms.
Genetic risk factors
Paget disease of the nipple is most often linked to an underlying breast cancer, so its inherited risks mostly overlap with breast cancer risk. There is no single known inherited cause behind most cases, and many people with Paget disease of the nipple do not have a strong family history. Some risk factors are inherited through our genes, especially family patterns of breast or ovarian cancer and certain gene changes that raise breast cancer risk.
Family history: Having close relatives with breast cancer, especially at younger ages or across several generations, can point to a higher inherited risk. A family history of ovarian cancer, pancreatic cancer, or male breast cancer can also be a clue to an inherited cancer gene. This does not mean Paget disease will happen, but it can signal a family pattern linked to the underlying breast cancer.
BRCA1 and BRCA2: Inherited changes in BRCA1 or BRCA2 raise the chance of breast cancer and can also increase the risk of Paget disease of the nipple because this condition is often part of the same disease process. These gene changes are more likely to be suspected when breast, ovarian, pancreatic, or prostate cancer runs in the family or appears at a young age.
Other breast genes: Inherited changes in genes such as PALB2, CHEK2, or ATM can also raise breast cancer risk, though often less strongly than BRCA1 or BRCA2. For some families, these changes may be part of the genetic risk factors for Paget disease of the nipple.
Rare syndromes: Uncommon inherited conditions involving genes such as TP53 or PTEN can make breast cancer more likely and may therefore raise the chance of Paget disease as well. Doctors usually think about these syndromes when several cancers occur in one family, when cancer starts very young, or when there are other unusual health features.
Breast tumor changes: Paget disease of the nipple often happens when cells from an underlying breast cancer spread into the skin of the nipple. Those cells usually carry the same DNA changes as the breast tumor, but these are usually acquired during life rather than inherited from a parent.
No single gene: So far, no inherited gene change has been shown to explain most cases of Paget disease of the nipple on its own. Many people living with this condition develop it without a clearly identified genetic reason.
Lifestyle risk factors
Paget disease of the nipple is usually linked to an underlying breast cancer, so lifestyle patterns that raise breast cancer risk can also matter here. The strongest lifestyle-related influences involve alcohol use, body weight, physical activity, and some hormone-related choices. Evidence for how lifestyle affects Paget disease of the nipple is mostly drawn from breast cancer research rather than from this rare condition alone.
Regular alcohol intake raises breast cancer risk, and that can increase the chance of cancers associated with Paget disease of the nipple. Risk tends to rise with the amount consumed over time.
Being overweight, especially after menopause, is linked to higher breast cancer risk through hormonal and inflammatory effects. This may increase the likelihood of underlying cancer presenting with nipple changes.
Sedentary habits are associated with a higher risk of breast cancer, while regular exercise appears protective. Physical activity also helps with weight control, which is one of the important lifestyle risk factors for Paget disease of the nipple.
No single food is known to cause Paget disease of the nipple, but long-term eating patterns that promote weight gain may indirectly raise risk. A diet centered on minimally processed foods can support healthier body weight and metabolic health.
Risk prevention
There is no guaranteed way to prevent Paget disease of the nipple, but many of the same steps that lower breast cancer risk may also help lower the chance of developing it. Prevention is about lowering risk, not eliminating it completely. Because Paget disease of the nipple is often linked to an underlying breast cancer, regular screening and paying attention to nipple or breast changes also matter.
A strong family history of breast cancer, certain inherited gene changes, older age, and past breast problems can raise risk. Knowing your personal risk helps you and your doctor decide whether you need earlier or more frequent screening for Paget disease of the nipple.
Keeping a healthy weight, especially after menopause, may help lower breast cancer risk. For many, this means aiming for steady habits with food, sleep, and activity rather than quick fixes.
Regular physical activity may lower the risk of breast cancer linked to Paget disease of the nipple. A practical goal is at least 150 minutes of moderate exercise each week, such as brisk walking, cycling, or swimming.
Drinking alcohol can raise breast cancer risk, and the risk goes up as intake increases. If you drink, cutting back can help reduce the chance of Paget disease of the nipple and other breast cancers.
Can you prevent Paget disease of the nipple?
There is no sure way to prevent Paget disease of the nipple. Because it is usually linked to breast cancer inside the breast, habits that may lower breast cancer risk, such as limiting alcohol, staying active, and keeping a healthy weight, may help but cannot guarantee prevention. Regular breast screening and getting new nipple changes checked quickly can help find it early, but they do not fully prevent it.
Transmission
Paget disease of the nipple is not infectious, so it cannot be passed from one person to another through touch, kissing, sex, shared clothing, or breastfeeding. If you are wondering whether Paget disease of the nipple is contagious, the answer is no.
Instead, Paget disease of the nipple usually develops as part of an underlying breast cancer, often when abnormal cells from deeper breast tissue reach the nipple area. It is also not usually inherited in a simple parent-to-child pattern, although a family history of breast cancer can raise overall risk for some people.
When to test your genes
Genetic testing is not routine just because you have Paget disease of the nipple. It becomes worth discussing if you have a strong personal or family history of breast, ovarian, pancreatic, or prostate cancer, especially at younger ages, because results can guide screening, surgery choices, and treatment.
Diagnosis
Paget disease of the nipple is usually diagnosed after ongoing nipple and areola changes, such as redness, scaling, itching, burning, or a sore that does not heal, prompt a medical visit. Because it can look like eczema or skin irritation at first, the diagnosis of Paget disease of the nipple often involves both a careful breast exam and tests to check for an underlying breast cancer. It’s natural to worry when symptoms don’t have a clear explanation.
Doctors usually begin with a close exam of the nipple, areola, and both breasts. They look for crusting, oozing, flattening of the nipple, skin thickening, or a lump deeper in the breast.
A small sample from the nipple or areola is taken and examined under a microscope. This is the key test to confirm Paget disease of the nipple and tell it apart from eczema or other skin conditions.
Breast X-rays are often used to look for an underlying tumor or suspicious calcium deposits. Even if the nipple changes are the main symptom, mammograms can help show whether cancer is present elsewhere in the breast.
An ultrasound may be added if there is a lump, dense breast tissue, or an unclear mammogram. It helps doctors look more closely at breast tissue and nearby lymph nodes without using radiation.
How is Paget disease of the nipple diagnosed?
Paget disease of the nipple is usually diagnosed when a doctor looks closely at ongoing nipple changes, such as redness, scaling, crusting, or discharge, and checks the breast for a lump or other warning signs. The key test is a biopsy, which means taking a small sample of skin from the nipple or nearby breast tissue and looking at it under a microscope. Because this condition is often linked to a deeper breast cancer, imaging tests such as a mammogram, ultrasound, or sometimes an MRI may also be used to look inside the breast.
Stages of Paget disease of the nipple
Paget disease of the nipple does not have defined progression stages. That is because it is usually identified by skin changes of the nipple and areola that are linked to an underlying breast cancer, rather than by a clear step-by-step pattern over time. Often the process begins when you notice changes in daily life, such as persistent nipple redness, scaling, itching, burning, or discharge, which can overlap with the early symptoms of Paget disease of the nipple. Doctors usually confirm it with a breast exam, imaging such as a mammogram, and a small skin sample called a biopsy, and follow-up is guided mainly by whether an underlying breast cancer is found and how extensive it is.
Outlook and prognosis
The outlook for Paget disease of the nipple is closely tied to whether there is an underlying breast cancer and how far it has spread at diagnosis. When found early and treated appropriately, especially if disease is limited to the nipple-areola area or associated with localized ductal carcinoma in situ, prognosis is often very good. Outcomes are generally less favorable when there is an invasive breast cancer, a palpable breast mass, lymph node involvement, or metastatic disease. Long-term survival therefore varies widely, but modern treatment with surgery and, when needed, radiation, endocrine therapy, chemotherapy, or targeted therapy can significantly improve control and survival. Mortality is mainly related to the stage and biology of the underlying breast cancer rather than the nipple changes themselves. Regular follow-up is important because recurrence risk depends on the original tumor stage, margins, and treatment received.
Long-term effects
For many people, the long-term outlook with Paget disease of the nipple depends less on the nipple rash itself and more on whether there is ductal carcinoma in situ or an invasive breast cancer underneath it. When found early, treatment can be very effective, but some people live with lasting changes from surgery, radiation, or the associated breast cancer. It’s important to remember that long-term doesn’t always mean progressive. Doctors may track these changes over years to see how Paget disease of the nipple and its treatment affect daily life.
One long-term concern is that breast cancer can come back in the same breast area or, less often, elsewhere in the body. This risk depends on the stage, whether the cancer was invasive, and which treatments were needed.
Many living with Paget disease of the nipple need years of follow-up visits and breast imaging. If the early symptoms of Paget disease of the nipple were subtle at first, this follow-up can be especially important for spotting new changes promptly.
Surgery can leave lasting changes in breast shape, nipple appearance, or chest sensation. For many, this can mean clothes fit differently or the area feels numb, tight, or unusually sensitive.
Some people have ongoing discomfort, scar tenderness, or tightness in the chest and shoulder after treatment. Radiation may also leave the skin firmer or more sensitive over time.
How is it to live with Paget disease of the nipple?
Living with Paget disease of the nipple can be unsettling because it often shows up in a very ordinary part of daily life: getting dressed, showering, exercising, or even noticing your bra or shirt rubbing against skin that feels sore, itchy, burning, or unusually sensitive. For many people, the emotional weight is just as real as the physical symptoms, because this condition is often linked to an underlying breast cancer, which can bring fear, repeated appointments, biopsies, surgery, and treatment decisions into everyday routines. Family and close friends are often affected too, not because the condition is contagious, but because they may step into caregiving roles, help with transport and appointments, and share the stress of uncertainty. With clear medical care and support, many people find that daily life becomes more manageable once they understand what is happening and have a treatment plan in place.
Treatment and drugs
Treatment for Paget disease of the nipple usually centers on treating the underlying breast cancer, which often means surgery and may also include radiation, drug treatment, or both. The exact plan depends on whether there is cancer deeper in the breast, how far it has spread, and the person’s overall health, so some people may need only local treatment while others need broader cancer care. Treatment plans often combine several approaches. These can include anti-cancer medicines such as chemotherapy, hormone-blocking treatment if the cancer is hormone-sensitive, or targeted drugs for certain tumor types, and creams or ointments alone are not enough to treat Paget disease of the nipple. After treatment, regular follow-up visits help check healing, watch for recurrence, and manage day-to-day issues such as pain, skin changes, or fatigue.
Can you cure Paget disease of the nipple?
Paget disease of the nipple can sometimes be cured, especially when it is found early, but treatment usually needs to treat both the nipple changes and any breast cancer underneath. Treatment often includes surgery and may also include radiation or medicine to lower the chance of the cancer coming back.
Non-drug treatment
Daily life with Paget disease of the nipple often starts with skin changes that do not settle, such as itching, burning, scaling, or a raw-looking nipple area. Treatment usually centers on procedures rather than medicines, because Paget disease of the nipple is commonly linked with breast cancer in the tissue underneath. For many, treatment begins not at the pharmacy, but with surgery and, in some cases, radiation, followed by recovery support and close follow-up.
Surgery is the main non-drug treatment for Paget disease of the nipple and aims to remove the nipple-area disease and any cancer underneath. This may involve breast-conserving surgery or mastectomy, depending on how much of the breast is affected and whether imaging or biopsy shows a deeper tumor. Reconstructive surgery may also be offered to help restore breast shape after treatment.
Many living with Paget disease of the nipple also need an assessment of the lymph nodes under the arm during surgery. This helps show whether cancer cells have spread beyond the breast and can guide the rest of treatment planning.
Radiation may be used after breast-conserving surgery to lower the chance of the cancer coming back in the treated breast. Treatment is usually given over a series of visits, and some may find the skin becomes red, dry, or tender for a time.
After surgery, careful wound and skin care can support healing and lower the risk of infection. Supportive therapies can include dressings, guidance on washing, and help managing friction from clothing while the area recovers.
Your genes may have an impact on how drugs work for you
For Paget disease of the nipple, medicine choices are usually shaped more by the type of breast cancer underneath the skin changes than by inherited genetic differences. In practice, doctors often test the tumor itself to see whether it is likely to respond to hormone-blocking treatment or to treatment that targets HER2, a growth signal some breast cancers use; this can help avoid giving medicines that are less likely to work. So while genes can matter in some cancers, for many living with Paget disease of the nipple, the biggest guide to drug response is the cancer’s own makeup rather than a person’s inherited DNA.
Pharmacological treatments
Drug treatment for Paget disease of the nipple is not the same for everyone, because medicines are usually chosen based on the breast cancer found underneath or alongside it. Many people with Paget disease of the nipple do not need medicine alone, and treatment often centers on surgery with or without radiation. When drugs are used, they may include hormone-blocking medicines, chemotherapy, and targeted drugs such as HER2-directed treatment. Not everyone responds to the same medication in the same way, and the plan depends on whether the cancer is hormone receptor-positive, HER2-positive, invasive, or more advanced.
Tamoxifen is often used when Paget disease of the nipple is linked to hormone receptor-positive breast cancer. It helps block estrogen signals that can drive cancer growth. This may be recommended after surgery to lower the chance of the cancer coming back.
Anastrozole, letrozole, and exemestane are commonly used after menopause for hormone receptor-positive disease. These medicines lower estrogen levels in the body rather than blocking the receptor directly. Sometimes medicines are taken short-term (acute treatment), while others are used long-term (maintenance therapy).
Chemotherapy may be used if there is invasive breast cancer, lymph node involvement, or higher-risk disease along with Paget disease of the nipple. Common drugs include doxorubicin, cyclophosphamide, paclitaxel, and docetaxel, often given in combinations. For some people, this is part of treatment when early symptoms of Paget disease of the nipple lead to the discovery of a larger underlying cancer.
Trastuzumab is used when the cancer is HER2-positive, and pertuzumab may be added in some cases. These drugs target a specific growth signal on cancer cells and are often given with chemotherapy. Heart function is usually checked during treatment because trastuzumab can affect the heart in some people.
Genetic influences
Because Paget disease of the nipple is usually linked to an underlying breast cancer, inherited breast cancer risk genes can matter here too. Genetics is only one piece of the puzzle, but changes passed down in genes such as BRCA1, BRCA2, and PALB2 may raise the risk of Paget disease of the nipple by increasing the chance of the breast cancers that can lead to it. A strong family history of breast, ovarian, pancreatic, or prostate cancer can be a clue that inherited risk is part of the picture, although many people with Paget disease of the nipple do not have a known inherited gene change. Some genetic changes are found only in the cancer cells themselves, so they are not passed through families. If Paget disease of the nipple develops at a younger age or alongside a notable family history, genetic counseling and sometimes testing may help clarify risk for you and your relatives.
Is Paget disease of the nipple genetic?
Genetics are not a major cause of Paget disease of the nipple in most people. It usually happens along with an underlying breast cancer rather than from a single inherited gene change. Family history can still matter for overall breast cancer risk.
Having a genetic risk is not necessarily a diagnosis
Gene changes are a normal part of human biology and are common in the general population. Most of these variants do not have a direct effect on health and simply reflect natural human diversity. For many genes, carrying a variant associated with a condition suggests a possible link rather than a certain diagnosis, especially when several genes and environmental factors are involved. In some cases, though, a single well-understood variant in a particular gene is enough to confirm a diagnosis.
Pharmacogenetics—how genetics influence drug effects
Although surgery is often the main treatment, the genes and other markers in the breast cancer linked to Paget disease of the nipple can shape which medicines are used before or after surgery. Doctors usually test the tumor for hormone receptors and HER2, because these results can show whether hormone-blocking treatment or HER2-targeted drugs are likely to help. If inherited testing finds a BRCA1 or BRCA2 change, that can also affect planning and, in some situations, open the door to targeted medicines called PARP inhibitors.
If you are wondering how genetic testing affects treatment for Paget disease of the nipple, most of the answer comes from these tumor and inherited gene results rather than from the nipple changes alone. Genetics is only one factor, and treatment decisions also depend on whether there is a noninvasive cancer or an invasive breast cancer underneath, the stage, and your overall health. Inherited differences in how the body processes medicine may sometimes matter for side effects or dosing, but this is not usually the main reason one drug is chosen over another in Paget disease of the nipple.
Interactions with other conditions
Paget disease of the nipple can sometimes be the first visible sign of an underlying breast cancer, so the skin changes are not always just a surface problem. Many living with Paget disease of the nipple notice itching, burning, flaking, or a rash-like area on the nipple and areola, and these changes may happen alongside a lump in the breast or abnormal discharge. Doctors call it a “comorbidity” when two conditions occur together, and in this case the most important overlap is with ductal carcinoma in situ or invasive breast cancer deeper in the breast tissue. This is why symptoms that seem similar to eczema, dermatitis, or a skin infection need careful assessment, especially if early symptoms of Paget disease of the nipple affect only one nipple and do not improve with usual skin treatments. People with Paget disease of the nipple may also need extra attention if they already have other breast conditions, because imaging, biopsy results, and treatment planning can become more complex. In practice, the key interaction is less about Paget disease of the nipple causing other illnesses and more about it being linked to another breast disease that needs prompt diagnosis and coordinated care.
How genes can cause diseases
Humans have more than 20,000 genes, each carrying out one or a few specific functions in the body. One gene instructs the body to digest lactose from milk, another tells the body how to build strong bones and another prevents the body's cells from beginning to multiply uncontrollably and developing into cancer. As all of these genes combined are the building instructions for our body, a defect in one of these genes can have severe health consequences.
Through decades of genetic research, we know the genetic code of any healthy/functional human gene. We have also identified that in certain positions on a gene, some individuals may have a different genetic letter from the one you have. We call these hotspots "Genetic Variations" or "Variants" in short. In many cases, studies have been able to show that having the genetic letter "G" in the position makes you healthy, but having the letter "A" in the same position disrupts the gene function and causes a disease. Genopedia allows you to view these variants in genes and summarizes all that we know from scientific research, which genetic letters (Genotype) have good or bad consequences on your health or on your traits.
What other conditions can cause similar symptoms to Paget disease of the nipple?
A scaly, itchy, sore, or oozing nipple can also be caused by eczema, a skin reaction such as contact dermatitis from soaps or creams, psoriasis, or a skin infection such as yeast. In people who are breastfeeding, irritation, cracking, or inflammation of the breast can look similar too. Because Paget disease of the nipple can also happen with an underlying breast cancer, doctors may also need to rule out other breast cancers, especially if there is nipple discharge, flattening of the nipple, or a breast lump.
History
A scaly, sore nipple that does not heal can seem like a minor skin problem at first. Many people living with Paget disease of the nipple are initially treated for eczema or irritation, especially when the area feels itchy, burns, or looks cracked. That early confusion has shaped the history of this condition as much as the disease itself.
In 1874, researchers described a pattern in which long-lasting changes of the nipple and areola were linked to cancer deeper in the breast. The condition was named after Sir James Paget, the British doctor who brought this connection to wider medical attention. First described in the medical literature as an unusual nipple rash associated with breast disease, Paget disease of the nipple was gradually recognized as more than a surface skin problem.
As medical knowledge improved, doctors learned that Paget disease of the nipple often appears alongside ductal carcinoma in situ or invasive breast cancer, although the exact pattern can vary from person to person. This helped explain why the early symptoms of Paget disease of the nipple can look deceptively simple at first, such as redness, flaking, oozing, or a flattened nipple, while the underlying issue may be more serious. Over time, better imaging, biopsy methods, and pathology testing made diagnosis more accurate.
Historically, Paget disease of the nipple was considered uncommon, and it still is relatively rare compared with other breast conditions. It has been reported most often in women, but men can develop it too. In recent decades, awareness has grown, which matters because earlier recognition can shorten the delay between first symptoms and the right diagnosis. Knowing this history helps explain why a nipple change that keeps coming back, or does not improve with standard skin treatments, deserves medical attention rather than being brushed off as ordinary irritation.