**Question:** True about Paget's disease of the nipple is:

A. It is a rare condition affecting elderly women
B. It is a benign condition, always associated with underlying invasive ductal carcinoma
C. It is a manifestation of underlying lobular carcinoma
D. It is a rare condition affecting elderly men

**Core Concept:** Paget's disease of the nipple is a rare skin condition characterized by the presence of abnormal cells that spread from the underlying breast tissue to the nipple-areolar complex. This condition occurs primarily in elderly women but can also affect men.

**Why the Correct Answer is Right:**

B. Paget's disease of the nipple is a benign condition is a misconception. Although it is a non-cancerous condition, it is often associated with underlying invasive ductal carcinoma in the breast, making it a precursor to breast cancer.

**Why Each Wrong Option is Incorrect:**

A. Although Paget's disease of the nipple is less common in men, it can still occur in men as well.
C. Paget's disease of the nipple is not always associated with underlying lobular carcinoma; it is typically associated with invasive ductal carcinoma.
D. The correct answer is B, as Paget's disease is a benign condition but is often associated with underlying breast cancer.

**Clinical Pearl:** The association between Paget's disease of the nipple and breast cancer highlights the importance of thorough physical examination and follow-up investigations for breast cancer in patients with Paget's disease, regardless of gender. Early detection can improve prognosis and management options for patients.