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Eguchi Y, Yoshinaka H, Hayashi N, Sueyoshi K, Uchikura K, Nomoto Y, Nagata A, Saho H, Shinden Y, Ohtsuka T. Accessory breast cancer in the inframammary region: a case report and review of the literature. Surg Case Rep 2021; 7:203. [PMID: 34495428 PMCID: PMC8426447 DOI: 10.1186/s40792-021-01285-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 08/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although a few cases of accessory breast cancer (ABC) have been reported, most were in the axillary region. We encountered an extremely rare case of ABC in the inframammary region (IMR). CASE PRESENTATION The patient was a 68-year-old postmenopausal woman who had noticed a congenital accessory nipple in her left IMR with slight, occasional discharge 20 years ago. Recently, she noticed a mass under the accessory nipple and visited a nearby clinic; fine-needle aspiration cytology of the mass revealed that it was malignant. She presented to our department 2 weeks after she had noticed the mass. Physical and imaging examinations showed an irregular tumor mass 1.7 × 1.4 × 1.0 cm in size connected to the accessory nipple beneath the left normal breast. Neither distant metastasis nor lymph node swelling was observed. Ultrasound-guided core needle biopsy revealed the mass to be invasive ductal carcinoma. We diagnosed her tumor as ABC in the left IMR; cT1cN0M0: stage IA. Curative wide resection with sentinel node biopsy was performed. Intraoperative evaluation of the frozen section revealed a hot and green ipsilateral axillary lymph node that was free from carcinoma; therefore, nodal dissection was avoided. Histopathological examination including immunochemical staining revealed that the tumor was invasive ductal carcinoma arising from the accessory breast tissue, scirrhous type, 1.7 × 1.4 × 1.0 cm in size, with a solid intraductal component. There was no lymphovascular infiltration, and the surgical margin was 1.5 cm or more. The tumor was estrogen and progesterone receptor-positive, Her2/neu-negative, and had a Ki-67 labeling index of 20%. There was no involvement of the three hot and/or green nodes. The final classification was pT1cN0(sn)M0: stage IA. Letrozole 2.5 mg/day will be administered for 5 years as adjuvant hormonal therapy. CONCLUSIONS A cutaneous and/or subcutaneous lesion except for proper breast tissue on the milk line, or mammary ridge from axilla to groin may be an accessory breast tissue. Its serial abnormalities must be worried malignant potential to ductal carcinoma which needs some imaging and pathological examinations for definitive diagnosis and appropriate treatment according to the usual orthotopic breast cancer without delay.
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Affiliation(s)
- Yuka Eguchi
- Department of Breast Surgery, Kagoshima City Hospital, 37-1 Uearata-chou, Kagoshima-shi, Kagoshima-ken, 890-8760, Japan.
| | - Heiji Yoshinaka
- Department of Breast Surgery, Kagoshima City Hospital, 37-1 Uearata-chou, Kagoshima-shi, Kagoshima-ken, 890-8760, Japan
| | - Naoki Hayashi
- Department of Breast Surgery, Kagoshima City Hospital, 37-1 Uearata-chou, Kagoshima-shi, Kagoshima-ken, 890-8760, Japan
| | - Kazunobu Sueyoshi
- Department of Pathology, Kagoshima City Hospital, Kagoshima-shi, Japan
| | | | - Yuki Nomoto
- Department of Digestive, Breast and Thyroid Surgery, Kagoshima University Hospital, Kagoshima-shi, Japan
| | - Ayako Nagata
- Department of Digestive, Breast and Thyroid Surgery, Kagoshima University Hospital, Kagoshima-shi, Japan
| | - Hazuki Saho
- Department of Digestive, Breast and Thyroid Surgery, Kagoshima University Hospital, Kagoshima-shi, Japan
| | - Yoshiaki Shinden
- Department of Digestive, Breast and Thyroid Surgery, Kagoshima University Hospital, Kagoshima-shi, Japan
| | - Takao Ohtsuka
- Department of Digestive, Breast and Thyroid Surgery, Kagoshima University Hospital, Kagoshima-shi, Japan
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Kahraman-Cetintas S, Turan-Ozdemir S, Topal U, Kurt M, Gokgoz S, Saraydaroglu O, Ozkan L. Carcinoma Originating from Aberrant Breast Tissue. A Case Report and Review of the Literature. TUMORI JOURNAL 2018; 94:440-3. [DOI: 10.1177/030089160809400327] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Carcinoma arising from ectopic breast tissue, either supernumerary breast or aberrant breast tissue, is extremely rare. Carcinoma occurs more frequently in the ectopic breast tissue of the axilla than in extra-axillary ectopic breast tissue. Here we report a case of an invasive lobular carcinoma arising from extra-axillary ectopic breast tissue and presenting as a subcutaneous nodule.
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Affiliation(s)
| | | | - Ugur Topal
- Department of Radiology, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Meral Kurt
- Department of Radiation Oncology, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Sehsuvar Gokgoz
- Department of Surgery, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Ozlem Saraydaroglu
- Department of Pathology, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Lutfi Ozkan
- Department of Radiation Oncology, Uludag University Faculty of Medicine, Bursa, Turkey
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Abstract
Breast neoplasm may develop in ectopically located glandular tissue. This paper presents an interesting and rare case of a 50-year-old female who despite regular mammography screening examination developed an invasive accessory breast cancer. Clinical examination revealed a 2 cm - tumour localized 4 cm below the left inframammary fold. The lesion was immobile, the skin and the atrophic nipple were retracted, the tumour infiltrated the thoracic wall. Oligobiopsy and additional examinations showed an invasive stage IIIB ductal breast cancer (Bloom II, G-2). The receptor status was: ER(+), PGR(+), HER2(-). The increased level of cancer antigen 15.3 was found. The patient was submitted to pre-operative chemotherapy. She also underwent surgery and subsequently post-operative chemotherapy and radiotherapy. On the basis of the presented case, it could be concluded that the accessory mammary glands are out of the image of screening breast examinations. Accessory breast cancer is usually diagnosed by clinical examination and ultrasonography. Preventive resection of accessory breast in women at high risk of developing breast cancer can be considered as the treatment of choice in most patients.
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Ghosn SH, Khatri KA, Bhawan J. Bilateral aberrant axillary breast tissue mimicking lipomas: report of a case and review of the literature. J Cutan Pathol 2008; 34 Suppl 1:9-13. [PMID: 17997730 DOI: 10.1111/j.1600-0560.2006.00713.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A 31 year old Indian woman presented with bilateral axillary masses that became noticeable with the onset of puberty. The masses exhibited similar consistency to the adjacent normal breast tissue but lacked an associated nipple complex. The clinical impression was lipoma; however, mammography, ultrasonography and skin biopsy revealed ectopic breast tissue. These findings were consistent with the diagnosis of aberrant breast tissue. A subset of ectopic mammary tissue, aberrant breast tissue may constitute a diagnostic challenge and is often misdiagnosed as lipoma, hidradenitis, follicular cyst, or lymphadenopathy. In addition, some studies have suggested that aberrant breast tissue may be at higher risk of malignant degeneration. Therefore, it's important that physicians be familiar with this condition as this may contribute to the early detection of ectopic breast cancer.
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Affiliation(s)
- Samer H Ghosn
- Department of Dermatology, American University of Beirut Medical Center, Riad El Solh, Beirut, Lebanon.
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Capobianco G, Spaliviero B, Dessole S, Rocca PC, Cherchi PL, Ambrosini G, Meloni F, Meloni GB. Lymph node axillary metastasis from occult contralateral infiltrating lobular carcinoma arising in accessory breast: MRI diagnosis. Breast J 2007; 13:305-7. [PMID: 17461909 DOI: 10.1111/j.1524-4741.2007.00428.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We describe a case of right axillary lymph node metastasis of an occult infiltrating lobular carcinoma arising from accessory mammary gland of the left upper anterior chest wall. Ultrasonography and mammography were normal bilaterally. Magnetic resonance imaging (MRI) revealed a 3.34 cm inhomogeneous lesion. Then, core biopsy under ultrasound guidance demonstrated a typical infiltrating breast lobular carcinoma. To our knowledge, this is the first case reported in the literature of an axillary lymph node metastasis from an occult contralateral infiltrating lobular carcinoma of the accessory breast tissue. MRI was useful for assessing the lesion of the accessory breast tissue.
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Affiliation(s)
- Giampiero Capobianco
- Department of Pharmacology, Gynecology and Obstetrics, University of Sassari, Sassari, Italy.
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