Many women
have received an email warning that a "new form of breast cancer"
starts as a rash on a woman's breast, instead of showing up as a lump.
According to the email, a young woman developed a rash, similar to that
of young nursing mothers. The rash was treated with antibiotics, but
did not clear up. Her doctor sent her for a mammogram, which showed
a mass in her breast. The mass turned out to be cancer, a type called
"Paget's disease of the breast."
This Internet
story is actually based on truth. Although this type of breast cancer
is not "new," it is rare. According to information on the
National Cancer Institute's website (
www.nci.nih.gov),
Paget's disease of the breast is a rare form of breast cancer that makes
up 1 to 4 percent of all breast cancer cases. The NCI site reports that
scientists are not sure how the disease occurs, but there are two theories.
One theory is that cells from a tumor in the breast move through the
milk ducts to the skin of the nipple; the other theory is that skin
cells on the nipple spontaneously become cancerous.
The signs
of Paget's disease include scaling and crusting lesions on the skin
of the nipple or areola, discharge, nipple inversion, flattening of
the nipple or a lump. Paget's disease of the breast is often confused
with skin conditions like eczema. It usually affects women who are middle-aged,
but can occur later. It can also very rarely affect men.
According
to the NCI, most people with Paget's disease have an underlying breast
cancer as well. People who have Paget's disease but who do not have
a breast lump that can be felt usually have "ductal carcinoma in
situ" (DCIS), where cancerous cells are in the milk duct linings
but have not spread. People who have a lump usually have an invasive
cancer.
Treatment
of Paget's disease depends on how far the cancer has advanced. If there
is no underlying cancer, only radiation may be necessary. DCIS or a
small tumor may only require a lumpectomy, which is the removal of the
lump plus the surrounding tissue. A larger tumor may require a mastectomy.
A doctor
may test for Paget's disease of the breast by a biopsy, by scraping
cells from the affected area and examining them under a microscope,
or by mammogram. It is recommended that women see a health care provider
if they notice any lumps, sores, discharge or rashes, or if a rash on
the breast does not clear up after treatment.
It is important not to confuse Paget’s disease of the nipple with
inflammatory breast cancer, another rare but serious breast condition
that also produces external symptoms. For more information see
What
Women Need to Know about Inflammatory Breast Cancer.
