Paget's disease of the breast physical examination

Common physical examination findings of Paget’s disease of the breast include eczematous appearance of the nipple associated with yellowish or bloody discharge.

Physical examination of patients should be perform both in sitting position and supine position to examine breast abnormalities.^[1][2]

• Nipple and areolar chnages:

• Crusting, ulcers or scaling on the nipple followed by the areola
• Discharge from nipple (often bloody)
• Inverted nipple

• Bilateral breast examination to check for palpable mass or lump:

• Lump may be attached to the skin or chest wall and cannot be moved.
• The lump may feel hard, irregular in shape and very different from the rest of the breast tissue
• The lump may be tender, but it is usually not painful.
• Change in size of affected breast

• Skin changes:

• Dimpling of the skin
• Thickening and dimpling of the skin (Peau d’orange).

• Lymphadenopathy maybe present in axillary cervicall and supraclavicular lymph nodes and determination of size, mobility, and number are essential.

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  Paget’s disease. Adapted from Dermatology Atlas.^[3]
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  Paget’s disease. Adapted from Dermatology Atlas.^[3]
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  Paget’s disease. Adapted from Dermatology Atlas.^[3]
• 
  Paget’s disease. Adapted from Dermatology Atlas.^[3]
• 
  Paget’s disease. Adapted from Dermatology Atlas.^[3]
• 
  Paget’s disease. Adapted from Dermatology Atlas.^[3]
• 
  Paget’s disease. Adapted from Dermatology Atlas.^[3]