Paget disease of the breast: An often-overlooked malignancy

Paget disease (PD) of the breast is a rare malignancy of the nipple-areola region that is almost always associated with an underlying in situ or invasive carcinoma. It can affect both women and men. It is more commonly seen in postmenopausal women. Clinical features may be the only sign of cancer during the initial presentation, making a diagnosis challenging. Early changes in PD include itching, scaling, and erythema of the nipple that can mimic other benign conditions, such as eczema. Histologically, it is characterized by an intraepidermal proliferation of malignant glandular epithelial cells in the nipple-areolar region. Imaging plays an important role in evaluating the extent of involvement and in deciding patient management. This article will provide an overview of the clinical features, histopathology, associated imaging findings, and management of PD.