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Undergo breast-conserving surgery if you don't have a lump. Get a mastectomy if you have a tumor. Go through adjuvant therapy to follow up after your surgery.

Article:
If you have Paget’s disease but do not have a lump, you may be able to undergo a surgery that saves the breast. Your nipple and areola will be removed, but the breast will remain intact. You may also need to get surrounding tissue removed near the nipple area. If you have Paget’s disease of the breast and a tumor, you will need to have a mastectomy. If the cancer has spread to the lymph nodes, you may need to have those removed as well. The stage of the cancer and size of the breast tumor will determine what related treatment, such as chemotherapy or additional surgery, will be needed. Depending on the severity of your condition and what  operation you have had done, you may need follow up adjuvant therapy. If you have breast-conserving surgery, you more than likely will be given whole breast radiation. For a mastectomy, your doctor may suggest radiation therapy, chemotherapy, or hormonal therapy. This depends on the stage of the cancer, the size and type of tumor, and if the lymph nodes are also affected.