Is early Paget's disease always a diagnosis that is made by a dermatologist with a biopsy or by a breast surgeon? I am concerned about a skin change to my nipple (right breast, no discharge, nipple only, white in color, not itchy) and have been referred by my primary Dr. to a breast surgeon and now to a dermatologist, whom the surgeon said would want to perform a biopsy. If it is not Paget's what would a biopsy by a Dermatologist be looking for?