Paget’s Disease of the Nipple-
My name is Nick Broviak. I am currently enrolled in the RN program at Ivy
Tech College of Indianapolis, IN. Throughout the semester we have been
exploring multiple aspects of Obstetrics. One of the areas I took notice of
was a condition called Paget’s disease of the nipple. I didn’t think I had
read it correctly, but apparently I had. I know Paget’s disease as the
condition usually characteristic of abnormal bone growth. So as I speculate
and critically work my way through the pathophysiology… I don’t get very
far. I don’t get much past GO, because breast tissue is composed mostly of
adipose tissue, not bone. Breasts made of bone would make it exceedingly
difficult to facilitate the production and passage of milk. After arriving
at this award winning conclusion, I decided to investigate just a little bit
deeper. I felt fairly comfortable with my grasp of Paget’s disease, but not
so confident about the nipple condition. Nursing school, as most nurses
remember, requires a student to establish multiple and consistent resources
of correct information. I’m not sure if anyone has ever relied so heavily
on a resource as I rely on Stedman’s Medical Dictionary for the Health
Professions and Nursing. It is my secret decoder ring for medical
terminology. I was unpleasantly surprised that, Paget’s disease of the
nipple didn’t make the cut. It did serve to reinforce my initial
understanding of the bone condition. Stedman didn’t help. What resource
did pull through, was my second in command, www.webmd.com. Paget’s disease
of the nipple, also called Paget’s disease of the breast, is actually a type
of cancer that forms around the nipple. Maybe one of the reason’s it caught
my attention is because it occurs so infrequently. The article said it
occurs in less than five percent of all breast cancers. On an irrelevant
note, I also learned that there is a Paget’s disease of the vulva. Some of
the signs and symptoms of the nipple condition include pain, itching,
scaling of the nipple skin, and potential for nipple discharge. As I wind
my way through this discovery, I begin to wonder what complications would
arise if a postpartum mother, with the condition, chose to breastfeed her
child. If the signs and symptoms present the way they do, I would
anticipate difficulty in the mechanics. How will the newborn secure a firm
and consistent latch with excoriated and scaling nipple tissue? Can mom
tolerate continued and regular feedings? Would a barrier be used? After
all of the speculating, one question seemed twelve times as important as the
others. Have risk factors been identified for maternal-infant transmission?
References:
1. DeVita,VT Jr., Hellman S, Rosenberg SA, editors. Cancer: Principles and
Practice of Oncology. 7th ed. Philadelphia: Lippincott Williams and Wilkins,
2004.
2. Kaelin CM. Paget’s Disease. In: Harris JR, Lippman ME, Morrow M, Osborne
CK, editors. Diseases of the Breast. 3rd ed. Philadelphia: Lippincott
Williams and Wilkins, 2004.
3. Martorana, Clare A., Breast Cancer Health Center, Paget’s Disease of the
Nipple. Retrieved on October 5, 2007, from http://www.webmd.com
4. Niederhuber, M.D., John E., Paget’s Disease of the Nipple: Questions and
Answers. Retrieved October 5, 2007, from http://www.cancer.gov
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