Thane woman's three-month nipple scaling turns out to be early-stage Paget's disease of the breast

Peeling or crusting of the skin on the nipple often looks like an ordinary skin condition. But if the problem persists despite treatment, a medical examination is necessary to find the cause. This was the lesson from the case of a 51-year-old woman from Thane. The skin around her nipple had been peeling for about three months, so she consulted a specialist. Further tests revealed early-stage breast cancer.

The woman had peeling and crusting of the skin around the nipple. She had tried several kinds of local treatment for eczema-like symptoms, but her condition did not improve much. She then got herself examined at KIMS Hospital in Thane, where Dr Vani Parmar, head of the breast cancer surgery department, examined her.

During the examination, it was noticed that the problem might not be limited to the skin. A subsequent mammography found microcalcifications, fine deposits of calcium, spreading from the central part of the breast towards the armpit. A biopsy was then done, which showed that the woman had Paget's disease of the breast and ductal carcinoma in situ (DCIS).

Paget's disease is a rare form of breast cancer. It can affect the nipple and the skin around it. Symptoms can include peeling, redness, itching, burning and crusting. These resemble common skin conditions such as eczema, so there is a risk that the disease is detected late.

According to the final pathology report, the cancer was confined to DCIS, the non-invasive form. There was no evidence of it spreading into surrounding tissue. The patient underwent breast-conserving surgery. As the affected area included the nipple, it was removed and reconstructed. Further tests showed that the cancer was hormone-sensitive, and the treatment plan included radiotherapy and hormonal treatment accordingly. According to the doctors, chemotherapy was not needed.

Dr Parmar says that if changes in the nipple or the skin around it persist despite proper treatment, they should not be ignored. Not every skin change is a sign of cancer, but if symptoms persist, consulting a specialist is essential. Persistent itching of the nipple, peeling, crusting, redness, sores or unusual discharge should prompt a medical examination. Symptoms such as a new lump in the breast or a change in its shape should also not be taken lightly.

The case offers an important lesson. If a skin problem of the nipple does not subside after treatment, patients should get further tests done by a doctor rather than continue treating it as merely a skin condition. If the disease is detected early, the right treatment can be planned.