If you have Paget's disease of the breast, you will likely need surgery. The type of surgery depends on the condition of the skin around your nipple and how advanced the underlying cancer is.
Surgical options include:
- Simple mastectomy. This procedure involves removing your entire breast, but not the lymph nodes in your armpit (axillary lymph nodes). A simple mastectomy might be recommended in cases in which an underlying breast cancer exists but hasn't spread to the lymph nodes.
Lumpectomy. Breast-conserving surgery (lumpectomy) involves removing only the diseased portion of your breast.
Your surgeon removes your nipple and areola along with a wedge- or cone-shaped section of your breast. The surgeon focuses on removing as little breast tissue as possible, while ensuring that the tissue removed includes an outer margin free of cancer cells so that only healthy cells remain.
Lumpectomy to treat Paget's disease of the breast requires follow-up radiation therapy. Lumpectomy wouldn't be recommended if you can't have radiation therapy for some reason. Most women have nipple reconstruction after their treatment.
After your operation, your doctor may recommend additional treatment (adjuvant therapy) with anti-cancer drugs (chemotherapy), radiation therapy or hormone therapy to prevent a recurrence of breast cancer.
Your specific treatment will depend on the extent of the cancer and whether your tumor tests positive for certain characteristics, such as having estrogen or progesterone receptors.