Snap Shot A 78-year-old women presents with a scaly, eczematous rash involving and surrounding the nipple. Introduction Rare (1% of breast cancers) Underlying ductal carcinoma (DCIS or IDC) almost always present unlike Paget's disease of the vulva Presentation Presents with dermatitis or macular rash over nipple or areola Evaluation Diagnose with biopsy and mammogram (to look for an underlying cancer) Treatment Excision and radiation