Paget's Disease of the Breast Presenting as Nipple Ulceration with Normal Mammogram

Abstract

Paget's disease of the breast (PDB) is a rare disorder of the nipple-areola complex that may present clinically as a unilateral, eczematous, or ulcerated papule or plaque. This case highlights the importance of either punch or incisional wedge biopsy to establish a diagnosis of PDB for patients who present with chronic cutaneous changes of the nipple, areola, or skin of the breast, regardless of any previous normal mammogram or breast ultrasound. Mammography alone cannot rule out a diagnosis of PDB in a patient with cutaneous changes of the breast.