Diagnosis and Treatment of Male Accessory Breast Cancer: A Comprehensive Systematic Review

Carcinoma in a male accessory breast; Case report with literature review

INTRODUCTION AND IMPORTANCE

Accessory breast is a rare condition where regression of the mammary ridge fails. This ectopic breast can function as the same pectoral breast and respond to hormonal effects. Furthermore, in rare cases, it can develop into malignancy. A malignant accessory breast is very rare, especially in male patients. Although it had first been reported in a male in 1957, there were only a few reported cases following that with no sufficient epidemiological data.

CASE PRESENTATION

A 60-year-old male with right axilla swelling is thought to be a benign lesion for excision. However, histopathology study of the specimen showed malignant cells, and a diagnosis of metastasis has been made and referred to our hospital. We did a full staging workup and eventually diagnosed him with primary accessory breast carcinoma, cT1N0M0.

CLINICAL DISCUSSION

Diagnosis of male accessory breast cancer is challenging. Patients usually present with painless swelling. As it is very rare, the possibility of metastasis needs to be ruled out before the diagnosis is made. No current diagnostic and treatment guidelines for accessory breast cancer, and in current practice physicians follow the guidelines of regular breast cancer. Another difficulty with this disease is the estimation of its prognosis.

CONCLUSION

Although accessory breast cancer is rare, it can be seen even in males. In patients with a lesion alongside the milk line, accessory breast cancer should be on the differentials list. Further studies regarding epidemiology, diagnostics, treatment plan, and prognosis of the disease need to be carried out.

Unilateral giant axillary accessory breast in male: Case report

INTRODUCTION

Accessory breast tissue is a rare condition occurring in 1-3 % of males, primarily in the bilateral axillary region. Kajava Class I accessory breast, characterized by glandular tissue, an areola, and a nipple, is rarely reported. This case report highlights the clinical presentation, diagnostic approach, and management of this rare entity in an elderly male.

CASE PRESENTATION

A 72-year-old male presented with a left axillary swelling since his early twenties. Initially painless and lemon-sized, the mass progressively enlarged, extending over the left chest and flank, causing dis- comfort and restricting daily activities. Physical examination revealed a large, pedunculated mass measuring 25x15x10 cm in the left axilla, with a smooth surface and no skin color changes except in the nipple and areolar region. Diagnostic imaging and cytology confirmed the presence of glandular tissue, and biopsy validated the diagnosis with histologic findings that showed lobules of glandular tissue lined by bland, single-layered ductal and myoepithelial cells, disposed in a fibrous growth background. Additionally, there were foci of bland fat tissue in the histology. Surgical removal of the mass resulted in a successful outcome.

CLINICAL DISCUSSION

The occurrence of Kajava Class I accessory breast tissue in an elderly male is rare. It is important to consider accessory breast tissue in the differential diagnosis of long-standing unilateral axillary swellings. The diagnostic approach included clinical examination, imaging, and histopathology. Surgical excision provided symptomatic relief and pre- vented potential complications such as malignancy.

CONCLUSION

Kajava Class I accessory breast tissue, though rare, should be considered in elderly males with long-standing unilateral axillary swelling. Early recognition and surgical intervention are crucial for optimal outcomes.

Unilateral Enlarged Right Accessory Axillary Breast Tissue in a Male: A Case Report

Accessory breast tissue, associated with polymastia and polythelia, presents challenges and concerns, particularly when patients fear malignancy. While occurring in 1-6% of cases, accessory breasts, often located bilaterally in the axillae, necessitate careful examination. We report a 35-year-old male with painful axillary swelling who underwent high-resolution ultrasonography (HR-USG) and fine-needle aspiration cytology (FNAC), revealing proper axillary breast tissue. Subsequent excision biopsy confirmed accessory axillary breast without malignancy. In conclusion, surgical removal of accessory axillary breasts is advisable, addressing cosmetic concerns and minimizing cancer risks.

Unexpected presentation of accessory breast: vulvar accessory breast tissue: a case report

BACKGROUND

The accessory breast is composed of residual glandular mammary tissue that persists after normal embryonic development. The entity is so rare that it is easily neglected in the diagnosis of disease.

CASE PRESENTATION

We report a 24-year-old virgin Persian woman with a left-sided vulvar mass and no pain or discomfort until shortly before her presentation at our department. Ectopic breast tissue in the vulva was diagnosed. We performed wide local resection of the lesion. Pathological investigation of the lesion confirmed the presence of ectopic breast tissue with secretory changes. She had no specific developmental abnormalities and had no relevant family history. She was followed up for 10 months and had recovered fully by this time.

CONCLUSION

Accessory breast tissue should be considered as a diagnosis when a mass is seen along the embryonic milk line, especially if the clinical findings reveal changes in the mass accompanied by changes in sex hormones.

First report of bilateral synchronous male accessory breast cancer

Accessory breast occurs due to the persistence of milk line in the non-thoracic region. Malignant transformation in male accessory breast is very rare, with 16 reports documented across the world. No bilateral synchronous accessory male breast cancer has been reported. We present the first case reported globally of a man in his 70s with a complaint of left axillary lump and chronic rash for 3 years. About 1 year ago, additional reddish rash was detected in the right axilla. Initial skin biopsy from a private hospital confirmed mammary carcinoma with skin invasion. Subsequent left breast mastectomy with left axillary lymph node dissection and right wide excision was performed. Final pathological result was grade 2 invasive ductal carcinoma in the left accessory breast and Paget's disease in the contralateral axilla. Postoperative treatment of adjuvant paclitaxel and trastuzumab was prescribed, which was followed by adjuvant radiation therapy.

rare cancer in an unexpected ectopic

Accessory Breasts can occur anywhere along the milk line extending from the axilla to the groin. In view of cosmetic reasons, accessory breasts are removed. We present three cases of accessory breasts with intra-cystic papillary carcinoma in them. Intra-cystic papillary carcinoma is a rare carcinoma that has finger like projections. It has a good prognosis and hence a simple excision biopsy is enough for these patients.