Paget’s Disease of the Breast (पैजेट डिजीज ऑफ़ द ब्रेस्ट) एक rare type of breast cancer है, जो nipple और areola के cells को प्रभावित करता है।
- पहली बार इसे Sir James Paget ने 1874 में describe किया।
- अक्सर यह underlying ductal carcinoma (DCIS या invasive carcinoma) के साथ जुड़ा होता है।
- Mostly middle-aged women (50–60 years) में देखा जाता है, लेकिन rare cases में पुरुषों में भी हो सकता है।
Paget’s Disease of the Breast क्या है (What is Paget’s Disease of the Breast)
- Cancerous changes in epidermal cells of nipple and areola
- Characterized by Paget cells – large cells with clear cytoplasm and prominent nuclei
- Often associated with underlying breast malignancy
- Early detection critical for better prognosis
Paget’s Disease of the Breast कारण (Causes of Paget’s Disease of the Breast)
1. Underlying Breast Cancer
- Ductal Carcinoma In Situ (DCIS)
- Invasive ductal carcinoma
2. Genetic Factors
- BRCA1 / BRCA2 mutation may increase risk
- Family history of breast cancer
3. Hormonal & Environmental Factors
- Hormonal imbalance, age-related risk
- Lifestyle factors: obesity, alcohol, smoking
4. Unknown / Idiopathic
- Exact trigger in some cases not known
Paget’s Disease of the Breast लक्षण (Symptoms of Paget’s Disease of the Breast)
- Redness or eczema-like rash on nipple and areola
- Itching, burning sensation
- Nipple discharge, sometimes bloody
- Flattening or inversion of nipple
- Scaling, crusting, or ulceration
- Underlying breast lump may be present
Early stage में rash के कारण often eczema या dermatitis से confuse किया जा सकता है।
Paget’s Disease of the Breast कैसे पहचाने (Diagnosis of Paget’s Disease of the Breast)
- Physical Examination – inspect nipple, areola, and surrounding skin
- Mammography / Ultrasound – detect underlying tumor
- Biopsy of nipple skin – confirm presence of Paget cells
- MRI (if needed) – detect occult breast lesions
- Hormone Receptor / HER2 testing – for targeted therapy planning
Early diagnosis critical for curative treatment।
Paget’s Disease of the Breast इलाज (Treatment of Paget’s Disease of the Breast)
1. Surgical Treatment
- Mastectomy – removal of entire breast, especially if underlying carcinoma present
- Breast-conserving surgery – removal of nipple-areola complex with surrounding tissue in select cases
2. Radiation Therapy
- Often given after breast-conserving surgery
- Reduces local recurrence risk
3. Chemotherapy / Targeted Therapy
- Required if invasive carcinoma or lymph node involvement
- HER2-positive tumors may receive trastuzumab (Herceptin)
4. Hormonal Therapy
- Tamoxifen or aromatase inhibitors for ER/PR-positive tumors
5. Follow-up & Monitoring
- Regular clinical examination and imaging
- Monitor for recurrence or metastasis
रोकथाम (Prevention)
- Regular breast self-examination
- Mammography screening from age 40 (or earlier if high-risk)
- Manage risk factors: maintain healthy weight, avoid smoking and alcohol
- Genetic counseling if family history present
सावधानियाँ (Precautions)
- Never ignore persistent nipple rash, discharge, or inversion
- Early medical consultation for any breast changes
- Adhere to treatment and follow-up schedules
- Report new lumps or skin changes immediately
FAQs (अक्सर पूछे जाने वाले प्रश्न)
Q1. Paget’s disease common है?
नहीं, यह rare है, लगभग 1–4% of all breast cancers में होता है।
Q2. क्या यह सिर्फ महिलाओं में होता है?
Mostly women में होता है, लेकिन rare cases में men भी प्रभावित हो सकते हैं।
Q3. क्या यह cancer है?
हाँ, यह एक type of breast cancer है।
Q4. Prognosis कैसा है?
अगर early detected और underlying carcinoma small हो, prognosis अच्छा होता है।
निष्कर्ष (Conclusion)
Paget’s Disease of the Breast (पैजेट डिजीज ऑफ़ द ब्रेस्ट) एक rare breast malignancy है, जो nipple और areola को प्रभावित करती है।
Early detection, biopsy, appropriate surgery, and adjuvant therapy से curative outcome संभव है।
अगर किसी को persistent nipple rash, discharge या lump महसूस हो, तो तुरंत breast specialist / oncologist से consultation आवश्यक है।