A 62-year-old woman presents with a 6-month history of an eczematous, scaly, rash near her nipple. It is mildly pruritic. On physical examination, the nipple and the areola are involved (Figure 96-1). Also, a hard mass is present in the lateral lower quadrant of the same breast. A 4-mm punch biopsy of the affected area including the nipple demonstrates Paget disease. The mammogram is suspicious for breast cancer at the site of the mass, and the patient is referred to a breast surgeon.
Paget disease of the breast is a low-grade malignancy of the breast that is often associated with other malignancies. It is an important consideration when working up a chronic persistent abnormality of the nipple.
Paget's disease, mammary Paget disease.