[Paget’s disease of the nipple]

Area of Science:

• Oncology
• Dermatology
• Pathology

Background:

• Paget's disease of the nipple is a rare breast malignancy, accounting for approximately 1% of all breast cancers.
• It typically manifests as unilateral eczematoid changes affecting the nipple, areola, or surrounding skin.
• Symptoms may include localized pain, itching, or stinging sensations.

Observation:

• A case involving a female patient in her sixties with an 18-month history of a nipple rash is presented.
• Initial imaging (ultrasound, mammography) did not reveal underlying pathology.
• Clinical suspicion and subsequent punch biopsies confirmed ductal carcinoma in situ.

Findings:

• The case highlights a diagnostic challenge where initial investigations were inconclusive.
• Repeated surgical excisions were necessary to achieve complete removal of the malignancy.
• Paget's disease of the nipple requires thorough histopathological examination for accurate diagnosis.

Implications:

• Eczematoid changes in the nipple area warrant a high index of suspicion for underlying malignancy, such as ductal carcinoma in situ.
• Prompt and accurate diagnosis through biopsy is essential for effective treatment and management.
• This condition underscores the importance of integrating dermatological and oncological assessments in clinical practice.