Mammary Paget’s disease (MPD) of the breast is a rare form of breast cancer. It accounts for a very small percentage of breast cancers in women, and much less in men It rarely occurs as an isolated entity and is usually associated with carcinoma in situ or invasive adenocarcinoma in most cases. In situ histology is seen in one third of the cases. Paget’s disease is rarely diagnosed in people under the age of 45. Paget’s disease affects people of all ethnic and racial groups. However, people of Asian descent are less likely to be affected. Surgical treatment of Paget’s disease (radical or conservative) is controversial. There is no established standardized treatment, and treatment decisions are based on other associated conditions. There is currently no evidence that either surgical approach (conservative surgery or mastectomy) improves survival. Prognosis depends on the presence of a palpable mass and the invasiveness of the cancer. We present a case of a 37-year-old woman who presented with recurrent mixed ductal lobular carcinoma associated with Paget’s disease. Paget’s disease diagnosis was completely established based on cytology material sampling only. The patient was treated with bilateral mastectomy with no nipple sparing. The patient was followed for four years with no evidence of metastasis or recurrence.