Pagets disease of the nipple with underlying occult invasive carcinoma discovered through lymph node biopsy: Case report

Paget's disease of the nipple (PDN) is a rare and often misdiagnosed condition characterized by the infiltration of adenocarcinoma cells into the nipple epidermis. It poses substantial diagnostic and therapeutic challenges due to its similarity to benign dermatological conditions and its association with in situ or invasive carcinoma. This case study presents a rare and clinically challenging instance of occult breast cancer associated with Paget's disease of the nipple. Occult breast cancers are often not detectable through standard imaging methods, such as mammograms or ultrasounds, and may only be identified after symptoms appear or through more invasive diagnostic techniques. Paget’s disease, a form of breast cancer that affects the skin of the nipple and areola, can be particularly difficult to diagnose early, as its symptoms—such as itching, redness, or discharge—can often mimic benign dermatological conditions. In many cases, Paget’s disease is associated with an underlying invasive breast cancer that is not immediately apparent, making early detection and intervention critical. This case highlights the diagnostic journey of a patient presenting with atypical nipple symptoms, ultimately revealing an occult breast cancer linked to Paget’s disease. Through this case, we aim to emphasize the importance of a thorough clinical evaluation and multi-disciplinary approach to diagnosis, as well as the significance of early recognition in improving patient outcomes.