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Treatment

Paget's disease of the nipple is usually associated with breast cancer.

It's treated by removing the cancerous part of the breast, or sometimes the entire breast using a procedure called a mastectomy.

You can discuss any concerns you have with your oncologist (cancer specialist), who will be able to explain each phase of your treatment.

Surgery

If you're diagnosed with Paget's disease of the nipple, surgery is often the first type of treatment you'll receive.

The 2 main types of surgery are:

These types of surgery will also involve removing your nipple and the darker area of skin surrounding it (the areola).

The 2 different types of surgery are discussed in more detail below.

Mastectomy

During a mastectomy, all of your breast tissue, including your nipple, will be removed. You may need to have a mastectomy if:

If lymph nodes (small glands) are removed from your armpit during a mastectomy, the scarring may block the filtering action of the lymph nodes, resulting in a condition called lymphoedema.

This is a long-term condition, but can be treated with:

Lymphoedema can develop months or sometimes years after surgery. Contact your GP or breast care nurse if you notice any swelling in your arm or hand on the side of your operation.

Read more about mastectomy.

Breast-conserving surgery

Breast-conserving surgery aims to save as much of your breast as possible while removing the cancer and a small amount of healthy tissue.

If you have Paget's disease of the nipple, your nipple and areola will be removed. You should be offered reconstructive surgery to improve the appearance of your breast after surgery (see below).

If you have breast-conserving surgery, the amount of breast tissue removed will depend on:

Your surgeon will remove some healthy breast tissue around the cancer so it can be tested for traces of cancer. If cancer cells are found in the surrounding tissue, more tissue may need to be removed from your breast.

After having breast-conserving surgery, it's likely you'll need to have radiotherapy to destroy any remaining cancer cells.

Read more about breast-conserving surgery.

Breast reconstruction

If you have a mastectomy, you may be able to have reconstructive surgery to recreate your breast. This can be done by:

The reconstruction can be carried out at the same time as your mastectomy or at a later stage. You should fully discuss your options with your surgeon and breast nurse before making a decision.

For example, it may be possible to have reconstructive surgery after breast-conserving surgery to improve the appearance of your breast and create a nipple.

A nipple can be created by:

Read more about breast reconstruction

Prostheses

If you decide not to have breast reconstruction, you can wear a false breast or breast prosthesis, which is available free on the NHS.

After having a mastectomy, you may have a temporary, fibre-filled prosthesis and a permanent prosthesis made from silicone, which can be replaced every 2 years.

Further treatment

After your surgery, you may need further treatment if you have invasive breast cancer (where the cancerous cells have spread into other tissue in your breast).

If you have non-invasive breast cancer (where the breast cancer cells are contained in 1 area of your breast), surgery may be the only treatment you need.

Other types of treatment for breast cancer include:

Read more about how breast cancer is treated.