Hi,
Paget Disease is a rare type of breast cancer and the chances of recurrence after a mastectomy and Tram Flap breast reconstruction will depend if the disease was associated with an underlying invasive or in situ cancer. If you didn’t have invasive cancer and you were diagnosed with simple Paget, then the chances of recurrence would be rather low. This lesion could be just a benign dermatological condition, however if you have any doubts and you are worried about it, I would advise you to contact your Breast surgeon as soon as possible. Any suspicious lesion requires prompt investigation.
Best wishes..