Paget's disease of the breast history and symptoms

Symptoms of Paget’s disease of the breast include itching, redness, thickened skin, and ulceration that begins at the nipple and spreads to the areola but can spread to surrounding skin. Lesion is sharply demarcated from the adjacent normal skin. Advanced lesions present as a round, ovoid or polycylic eczema-like plaque with a pink or red discoloration.

A detailed history documenting the length of time the lesion along with any associated symptoms should be taken.By clinical history, the cancer risk can be evaluated:^[1]

• Age at menarche

• Menopausal status
• Number of pregnancies
• Previous history of radiation
• History of oral contraceptives or hormone replacement therapy
• Past history of breast cancer and age at time of diagnosis
• Familial history of breast cancer or ovarian cancer in first-degree relatives
• Other associated breast disease or possible biopsies

Symptoms of Paget’s disease of the breast usually occur in one breast but can present bilaterally. Some patients have two or more or a combination of the below symptoms at presentation. They can also be asymptomatic. Symptoms of Paget’s disease of the breast include: ^{[2][3][4][5][6][7]}

• Pruritis or erythema of the nipple and/or areola.
• Flaking, crusting, or thickening of the skin that begins at the nipple and spreads to the areola with irregular borders but can spread to surrounding skin.
• Erosion or ulceration of the nipple.
• A flattened, inverted or retracted nipple.
• Bloody or serosanguinous discharge from the nipple.
• A palpable breast mass is present in 50% of patients.
• Advanced lesions present as a round, ovoid or polycylic eczema-like plaque with a pink or red discoloration.
• Lesion is sharply demarcated from the adjacent normal skin.

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