 [ Symptoms ] how is paget is disease of the nipple diagnosed [ Disease ] if a health care provider suspects paget is disease of the nipple a biopsy of the nipple skin is performed in a biopsy the doctor removes a small sample of tissue a pathologist examines the tissue under a microscope to see if paget cells are present the pathologist may use a technique called immunohistochemistry staining tissues to identify specific cells to differentiate paget cells from other cell types a sample of nipple discharge may also be examined under a microscope for the presence of paget cells because most people with paget is disease of the nipple also have underlying breast cancer physical examination and mammography x ray of the breast are used to make a complete diagnosis