How to diagnose breast paget’s disease? Paget’s disease of the breast, also known as eczema-like carcinoma of the breast, is a specific type of breast cancer that is less malignant and has a lower incidence. This disease is easily misdiagnosed at the first diagnosis because: it is easily confused with true nipple eczema. The main early manifestations of breast Paget disease are redness, itching, and slight pain of the nipple skin, and in some patients, a small amount of exudation, followed by thickening, oozing, crusting, and flaking of the skin in the areola area of the nipple or with erosion and ulceration of the nipple areola skin. This condition can heal temporarily under the scab after symptomatic treatment by a dermatologist and can recur many times. Therefore, when a woman has recurrent eczema-like skin changes, it is important to do consider if she has Paget’s disease of the breast. It is generally recommended that those with skin lesions in the nipple areola area that have not been treated for more than 2 weeks should have a pathological examination to rule out breast Paget’s disease. Since this disease is often associated with intraductal carcinoma or invasive ductal carcinoma of the breast, breast ultrasound or mammography should also be done to detect lesions in the breast to avoid missed diagnosis. The diagnosis of breast Paget’s disease is based on clinical manifestations and pathological examination, remembering that pathological examination must be done to find Paget’s cells as the basis for diagnosis. Commonly used are cytologic examination and pathologic examination by taking the whole skin layer of the lesion. Cytologic examination is a non-invasive test, usually first remove the scab from the lesion, remove the secretion, and then do cytology print, if accompanied by symptoms of papillary overflow, should also do overflow smear examination, multiple cytologic examination can help improve the diagnostic accuracy, however, from the current research reports, cytologic examination has a low rate of confirmation, cytology negative can not exclude the disease. The most reliable way to confirm the diagnosis is to do a whole skin biopsy, which is an invasive test with a small piece of whole skin cut from the lesion for pathological examination, but the diagnosis rate is high. Skin biopsy is minimally invasive, can be done on an outpatient basis, does not require hospitalization, and heals in about a week. If the pathology is positive, the diagnosis will be 100% confirmed. If repeated pathological examinations are negative, the disease can be basically excluded. However, for patients with high suspicion of this disease, it is recommended to examine the breast in detail to see if there are lumps and gravel-like calcified foci in the breast, and to do pathological examination if necessary; for patients with nipple overflow, the lesioned duct and the corresponding glandular lobe should be removed if necessary, and then pathological examination should be done to clarify the diagnosis.