Paget disease of the breast is a rare form of breast cancer that involves the nipple and often the areola as well (the dark circle of skin around the nipple). You may hear it called by other names, such as:
About 80 to 90% of people with Paget disease also have ductal carcinoma in situ (DCIS) or invasive breast cancer in the same breast. One or more tumors can be present.
Although researchers don’t fully understand what causes Paget disease, it may result from DCIS or invasive breast cancer cells moving through the milk ducts to the nipple and areola. However, this does not explain Paget disease of the breast that is found by itself, without an underlying breast cancer. More research is needed to fully understand why it happens.
Paget disease of the breast can be mistaken for skin conditions that cause irritation, such as dermatitis or eczema. The nipple and the skin around it can be itchy, red, and crusty.
Below, you can learn about who is more likely to be diagnosed with Paget disease, common symptoms, how Paget disease is diagnosed and treated, and what to know about follow-up care.
Paget disease of the breast usually affects women. It’s rarely found in men. While it can happen in women of any age, the average age at diagnosis is the late 50s.
About 1 to 4% of all breast cancer cases also involve Paget disease of the breast.
Paget disease of the breast usually occurs when there is another form of breast cancer somewhere else in the breast. The risk factors are the same as they are for breast cancer in general, such as:
Learn more about risk factors at What causes breast cancer?
Changes to the nipple and areola are often the first symptoms of Paget disease of the breast. These can include:
Doctors often mistake Paget disease of the breast for more routine skin conditions, such as eczema or dermatitis. This often can delay diagnosis. If unusual symptoms persist despite treatment, Paget disease of the breast should be considered.
Many people who have Paget disease of the breast also have a breast lump that can be felt during a clinical breast exam. That’s because another type of breast cancer, such as DCIS, invasive ductal carcinoma, or invasive lobular carcinoma, may also be present. It might or might not be big enough to feel, though. Your doctor should check the entire breast with a clinical breast exam and breast imaging, such as a mammogram, if there are nipple changes associated with Paget disease of the breast.
Mistaken signs really Paget disease
“For 6 months, I knew something wasn’t right and I kept going until I got an answer. You have to be responsible to take care of yourself.”
– Christina Ihfe, whose painful nipple rash was eventually diagnosed as Paget disease of the breast.
The first step of diagnosing Paget disease is a biopsy to check the cells in the nipple and areola where the changes have occurred. Paget cells have a large, round appearance when examined under a microscope.
There are a few different approaches to nipple biopsy:
Sometimes, the entire nipple may need to be removed.
If Paget disease of the breast is diagnosed, your doctor will perform other tests of the affected breast. These may include:
Your treatment plan for Paget disease of the breast depends on:
Treatment options include:
If another type of breast cancer is found in addition to Paget disease of the breast, treatment may also include:
Your care team can help you develop a treatment plan based on the features of the breast cancer, such as:
For more information on treatment for other types of breast cancer, visit:
Your follow-up care recommendations depend on the stage and features of the cancer, and whether Paget disease of the breast was found alone or with another type of breast cancer.
Follow-up often includes:
Learn more at When to have follow-up visits.
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Reviewed and updated: February 15, 2026
Reviewed by: Jennifer Plichta, MD
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