Paget’s disease of the nipple: Know it to tackle it
The primary characteristic of Paget’s disease of the nipple is that the syndrome strikes the portion around the nipple or the nipples of the both the breasts. This cancerous disease can also begin from the nipple or from anywhere within the breast. Therefore, it is always advisable to keep ourselves abreast about the ailment so that its symptoms are diagnosed at their early stages for quick recuperation.
CAUSES OF PAGET DISEASE OF THE NIPPLE
Research is on to pinpoint the exact cause of Paget disease of the nipple. There is no unanimity as to the exact cause of this ailment. However, two theories have found wide acceptance in the medical circles.
THE FIRST THEORY
The first one suggests that this disease of the nipple starts from the Paget cells which are cells that are cancerous and first form a tumor within the breast. Then these Paget cells move away from the originating place of the tumor via the milk tubes or ducts to strike the nipple surface. The reason for the acceptance of this theory is that approximately 98 per cent of the patients diagnosed with Paget’s disease of the nipple also report underlying (yet-to-be diagnosed) breast cancer that is invasive.
THE DCIS SYNDROME
This typically invasive and underlying breast cancer intricately connected with Paget’s disease of the nipple is technically termed ‘DCIS’ which is an acronym for ‘Ductal carcinoma in situ’. It is also known as ‘Intraductal carcinoma’.
When a patient is diagnosed with DCIS, it means that the abnormal or cancerous cells are yet to spread. Generally, such cells spread to the tissues around the affected region or to the lymph nodes. In other words, these unnatural cells are still in the breast. Their place is in the milk ducts.
If the syndromes are not diagnosed at the initial stages these cells can cause breast cancer that is quite invasive.
WHAT’S AN INVASIVE BREAST CANCER?
Invasive breast cancer spreads like wild fire. It moves outside the milk ducts into the tissues of the breast. In extreme cases, the abnormal cancerous cells also travel into the lymph nodes across the body, particularly in the arm-pit region.
THE SECOND MAJOR THEORY
This theory applies to two rare situations of Paget disease of the nipple. Proponents of this second theory propose that once afflicted with Paget’s disease of the nipple, the cells constituting the nipple automatically become cancerous or Paget cells.
They base their suggestions on the following observations, viz., there is an independent tumor diagnosed to be responsible for the underlying breast cancer; and in those instances where the patients do not suffer from any yet-to-be diagnosed breast cancer.
NIPPLES ITCHY: BEWARE
Notable is that 50 per cent of the patients suffering from this ailment can touch a lump in the breast. Another significant aspect is that Paget’s disease of the nipple begins with the nipple spread to many other portions of the breast or areola – the circular dark area around the nipple. The patient can experience eczema or itch on the nipple. Eczema is a red itch that is apparently non-cancerous.
DIAGNOSING PAGET’S DISEASE OF THE NIPPLE
The best means to diagnose Paget disease of the nipple is through biopsy. The moment there is a lump in the breasts, or the nipple skin has reddened or scalded to disappear one day, immediately report the matter to your health care provider. Pathologists carry out this process in two ways, viz., breast tissue and/or discharge form the nipple.
A small tissue of the breast or the afflicted portion is removed to be scanned. The objective is to ensure of there are cancerous cells or Paget cells. Many pathologists make use of the staining tissue method to ascertain the presence of Paget cell. It is clinically termed immunohistochemistry. This method differentiates the Paget cells from the other types of cells.
X-ray of the breasts (Mammography) and physical scanning of the breasts and the nipples are necessary for total analysis of Paget’s disease of the nipple. It helps in diagnosing underlying breast cancer.
