Dry skin on one nipple - Paget's?!

[maryjane91]

So, for the past few days I have noticed that the skin on one of my nipples is very dry and flaky. So far that's the only symptom - dry, flaky skin - but I am terrified that it's the early stages of mammary Paget's disease, since it's only on one nipple. I don't have eczema. I'm 28, have two kids and have no family history of breast cancer except my grandmother (after age 50).
Has anyone else had this? Some words of reassurance would be appreciated!

[Carys]

OK, firstly - you are 28. If you did have Paget's breast cancer (starting in the nipple) you would be medical literature/documenting case rare. Paget's is a very rare BC form in itself, accounting for a very small proportion of cases. So, thats good news for starters, as most cases are diagnosed in the 50 plus age group and the highest proportion in the 60 plus already stats are very much on your side ;). There is no doubt that Paget's in the early stages is confused with eczema, but it quickly becomes obvious that it is something more than eczema as the area becomes inflammed, rashy, red and scaley areas increase and the symptoms below start to show -



Itching, tingling, or redness in the nipple and/or areola
Flaking, crusty, or thickened skin on or around the nipple
A flattened nipple
Discharge from the nipple that may be yellowish or bloody


I have heard said that if the flakiness/dry skin comes away and the nipple skin is normal underneath then you more than likely have benign irritation of the skin and dermatitis (which incidentally is very sensitive to rubbing on even bra fabric). Have I had this before for no reason at all ? Its hard to say as I don't know the extent or what your flakiness looks like, and am only guessing, but yes over the years there have been times of dry skin in this area. I would say to you that benign skin changes on the nipple are the most likely reason for what you are describing, (are you breast feeding ?) and you could try some moisturising with good old fashioned vaseline or something and monitor. Even if the dry and flakiness doesn't go, it doesn't mean it's Paget's ! Pop along to your GP and see if you need some steroid cream or something and get them to assess.

I am presuming that you have done a breast tissue mannual check and there is nothing you can feel underneath the nipple area ?

Anyhow, I hope some other people will come along with similar 'symptoms' to yours, or people who have had those 'symptoms' in the past. I will say that most people at your age wouldn't have heard of Paget's, so I can only ask if you've been doing some internet searching ? Actually most people at my age (over 50) wouldn't know about it. Fess up.

[maryjane91]

Thank you Carys! I am no longer breastfeeding, through I did breastfeed my youngest until she was 3 - she's 4 1/2 now. I can still squeeze out a bit of milk though, that is white/yellow.

The skin underneath looks the same as the other nipple as far as I can see. I can't feel any lumps. I just wish it was on both nipples (or, preferably, none of them)! I have tried to moisturise with some jojoba oil, but it hasn't helped.

I know breast cancer is rare in my age group, but I also know it's not unheard of. /:

[Carys]

Is the milk/discharge from both sides? COuld it be that doing the squeezing set off the skin problem ?

[maryjane91]

The milk/discharge is mainly on the breast with the det nipple (the same breast that also producer more milk when I was breastfeeding), but from what I've heard breast milk is supposed to be good at healing the skin?

[Carys]

However, if the skin there is damp the whole time (as it might slightly be) then it could set off a skin issue.

[maryjane91]

I don't think it is damp...
And the problem persists. Still dry, cracked skin. Only visible close up, but still. Vaseline doesn't seem to help. :( The nipple looks otherwise normal, as far as I can see. Just dry and flaky. No itching or bleeding... I don't know if I should be worried or not - it just seems weird that the one nipple is so dry and the other one isn't at all :(

[Carys]

COuld be a fungal condition ? Why not just go get it looked at - obviously its bothering you, and no I don't think its Pagets - just that it could be cleared up with some simple cream or something ?

[maryjane91]

So... I'm back.

It sent away for a while. Some days it came back, but then the other nipple was a bit dry or scaly as well. So I concluded it was unlikely to be anything sinister, since the other nipple was affected as well, though not as much.

But now, it's back - on the one nipple only. It's just very dry and flaky. No redness or itching so far, nothing on the aerola. The skin is just very dry to the touch. And I know Paget's symptoms can come and go. I have a doctor's appointment this Thursday and will bring it up, but I am just very worried... Through the rational part of my brain tells me it's unlikely to be sinister. But then I look at my breast and I start to worry again... I know I have a tendency to dry skin, but why would it affect just the one nipple?!

[Midnight-mouse]

So... I'm back.

It sent away for a while. Some days it came back, but then the other nipple was a bit dry or scaly as well. So I concluded it was unlikely to be anything sinister, since the other nipple was affected as well, though not as much.

But now, it's back - on the one nipple only. It's just very dry and flaky. No redness or itching so far, nothing on the aerola. The skin is just very dry to the touch. And I know Paget's symptoms can come and go. I have a doctor's appointment this Thursday and will bring it up, but I am just very worried... Through the rational part of my brain tells me it's unlikely to be sinister. But then I look at my breast and I start to worry again... I know I have a tendency to dry skin, but why would it affect just the one nipple?!

Why does just one of my elbows get dry? Just one of my feet too! It’s just a thing of the body. We’re not symmetrical beings and the body just does things sometimes.

Bring it up with the doctor but likelihood is you just need some extra moisturiser!




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[Carys]

It won't be Paget's ! Its come and gone, gone to both sides, then back to one and you have a tendency to dry skin. You need to see this for what it is, and I have no doubt your doctor will not be concerned about Paget's.

[maryjane91]

Thank you for your replies! You're probably right. I'll try my best to calm down :)