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Abstract
AIM Ectopic breast tissue (EBT) includes a spectrum of disease that entails other entities based on the presence of glandular tissue, nipple, or areola. The diagnosis in adolescents is infrequent. METHODS A retrospective study was performed including girls with axillary EBT (class IV or V of Kajava's Classification) operated in 2006-2020. Imagining studies, clinical and surgical reports, and histopathology were reviewed. RESULTS Eleven girls from 13 to 16 years old were included. Two patients (18.2%) presented bilateral EBT. The most frequent clinical manifestation was 2-5 cm mass (100%), associating cyclic pain with menstruation (45%) and fluctuating volume (36%). Bilateral axillary ultrasonography allowed preoperative diagnosis. All of them were treated by open excision, through small incisions located in an axillary y fold. Clinical and aesthetic results were self-assessed as "very good", with normalization of the axillary y hollow and imperceptible scars. No recurrences were observed after one year of follow-up. An immediate postoperative hematoma was reported, which did not require drainage. Histopathology showed mature breast tissue without atypia. CONCLUSIONS Axillary accessory breasts must be included in differential diagnosis of pediatric axillary masses. Bilateral ultrasonography is recommended for the preoperative diagnosis. Excision through minimal incision at this age seems to be safe and effective.
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Affiliation(s)
- M De la Torre
- Division of Plastic Pediatric Surgery, Pediatric Surgery Department, Hospital General Universitario Gregorio Marañón, c/O'Donnell, 52, 28007, Madrid, Spain.
| | - C Lorca-García
- Division of Plastic Pediatric Surgery, Pediatric Surgery Department, Hospital General Universitario Gregorio Marañón, c/O'Donnell, 52, 28007, Madrid, Spain
| | - E de Tomás
- Division of Plastic Pediatric Surgery, Pediatric Surgery Department, Hospital General Universitario Gregorio Marañón, c/O'Donnell, 52, 28007, Madrid, Spain
| | - B Berenguer
- Division of Plastic Pediatric Surgery, Pediatric Surgery Department, Hospital General Universitario Gregorio Marañón, c/O'Donnell, 52, 28007, Madrid, Spain
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Pshtiwan LRA, Hammood ZD, Salih AM, Karim SO, Ali BS, Kakamad FH, Ali RK. Fibroadenoma in axillary accessory breast mimicking carcinoma of unknown primary; a case report with literature review. Ann Med Surg (Lond) 2022; 73:103179. [PMID: 35070276 PMCID: PMC8767229 DOI: 10.1016/j.amsu.2021.103179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/07/2021] [Accepted: 12/11/2021] [Indexed: 11/12/2022] Open
Abstract
Introduction Accessory breast (AB) is extra and ectopic breast tissue. Fibroadenoma (FA) in AB is a rare finding. This study aims to present a case of FA in axillary AB mimicking carcinoma of unknown primary (CUP). Case report A 38-year-old female presented with a mass in her right axilla. She had a mass in her right breast for 5 years. She previously had a left breast lumpectomy for a benign condition. The lump in her axilla was palpable and hard. Ultrasound showed an oval lymph node in the level I axilla (12*6mm) with blurred and unclear fatty hilum, suspicious for malignancy. Magnetic resonance imaging revealed an oval lesion (12*7mm) in the level I axilla with no fatty hilum and with heterogeneous enhancements, suggesting abnormal nodes. Fine needle aspiration of the axillary mass suspected CUP. But core biopsy resembled FA. Both masses in the right axilla and breast were surgically excised. Histopathology confirmed FA in both masses. Discussion Although pathologies in AB are uncommon, it is still susceptible to the same malignant and benign transformations that are found in normal breasts. The axilla is the most frequent location for FA in AB and often affects young women. Imaging techniques can be inconclusive and only histopathology can conclude a definitive diagnosis. Conclusion FA in axillary AB is a rare condition that causes a diagnostic dilemma as it can be mistaken for other benign or malignant pathologies. Accessory breast is having extra and ectopic breast tissue. Fibroadenoma in the accessory breast is a very rare finding. It can be mistaken for other malignant pathologies. This report presents a case of fibroadenoma in axillary accessory breast mimicking carcinoma of unknown primary.
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Affiliation(s)
- Lana R A Pshtiwan
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Zuhair D Hammood
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Abdulwahid M Salih
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq.,College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Sanaa O Karim
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq.,College of Nursing, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Bakhan Sharif Ali
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Fahmi H Kakamad
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq.,College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq.,Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq
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Oudsema R, Simpson W, Szabo J, Margolies LR. The mammary ridge-A case report of multiple ectopic breast masses. Clin Imaging 2017; 45:34-36. [PMID: 28600965 DOI: 10.1016/j.clinimag.2017.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 05/08/2017] [Accepted: 05/10/2017] [Indexed: 10/19/2022]
Abstract
Ectopic or accessory breasts describe residual breast tissue that fails to regress during normal embryologic development anywhere outside the expected locations. Ectopic breast tissue is seen in 2-6% of the population and is categorized into two types: supernumerary and aberrant breast tissue . The extent of development of this accessory tissue varies from rudimentary to complete with organized glandular and ductal development. Given this, it is possible for the same pathology that affects normally positioned breast tissue to also affect accessory breast tissue.
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Affiliation(s)
- Rebecca Oudsema
- Mount Sinai Hospital, Department of Radiology, Box 1234, One Gustave L Levy Place, New York, NY 10029, USA.
| | - William Simpson
- Mount Sinai Hospital, Department of Radiology, Box 1234, One Gustave L Levy Place, New York, NY 10029, USA.
| | - Janet Szabo
- Mount Sinai Hospital, Department of Radiology, Box 1234, One Gustave L Levy Place, New York, NY 10029, USA.
| | - Laurie R Margolies
- Mount Sinai Hospital, Department of Radiology, Box 1234, One Gustave L Levy Place, New York, NY 10029, USA.
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Affiliation(s)
- Prabal Deb
- Officer Commanding, 2 CBSU, c/o 56 APO, Military Hospital, Ambala Cantt 133 001
| | - D Swarup
- Classified Specialist (Pathology), #Classified Specialist (Obstetrics and Gynaecology), Military Hospital, Ambala Cantt 133 001
| | - G C Mishra
- Classified Specialist (Pathology), #Classified Specialist (Obstetrics and Gynaecology), Military Hospital, Ambala Cantt 133 001
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Abstract
INTRODUCTION Due to its minimally invasive and highly precise nature, the mammotome, a vacuum-assisted breast biopsy device, has proven effective for the treatment of benign breast lesions. Taking advantage of both liposuction and the mammotome, we utilized the mammotome device for the excision of accessory breasts. METHODS Between July 2010 and June 2014, 16 patients with accessory breasts received mammotome-assisted liposuction. After adipose was removed using this procedure, the mammotome system was used to excise the fibro-glandular tissue in accessory breasts under ultrasound monitoring. RESULTS All patients were satisfied with their appearance after surgery. A single 5-mm incision, which was well hidden in the axillary skin folds and allowed for restoration, provided an aesthetically pleasing contour to the axilla. CONCLUSIONS Mammotome-assisted liposuction is a new approach that can be used to excise both adipose and fibro-glandular breast tissue simultaneously with a minimal incision, and provides a favorable contour to the axilla. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Xin Tang
- Department of Breast Surgery, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, #17 Qihelou Street, Dong Cheng District, Beijing, 100006, China.
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Hwang SB, Choi BS, Byun GY, Koo BH, Lee SR. Accessory Axillary Breast Excision with Liposuction Using Minimal Incision: A Preliminary Report. Aesthetic Plast Surg 2017; 41:10-8. [PMID: 28032153 DOI: 10.1007/s00266-016-0729-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 10/21/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Accessory breasts have received little attention in the surgical fields, although the condition is quite common in the female population, with 2-6% of women suffering from it. Its convexity and cyclic pain make women feel embarrassed and uncomfortable, so patients often desire surgical excision to improve their appearances and to remove the pain. METHODS A total of 967 patients who had been treated by an excision of accessory breast tissue with liposuction using minimal incision from September 2013 to Dec 2015 at the Damsoyu Hospital were analyzed for clinical factors retrospectively. RESULTS All 967 patients were female. There were 514 (53.2%) unmarried patients and 453 (46.8%) married patients. The major clinical manifestation was the problem in the appearance with cyclic pain in both unmarried and married groups (82.7 vs. 87.9%). Three types of accessory breasts were observed: 779 (80.6%) breast tissue only in axillae, 182 (18.8%) breast tissue with accessory nipple, and 6 (0.6%) breast tissue with accessory nipple-areolar complex. The mean operation time was 58 min. All cyclic axillar pain in our cases was resolved after the operation. Postoperative complications developed in 160 patients (16.55%). Among them, seroma after operation was the most common (11.27%). In our study, 95.65% of the patients were satisfied with the cosmetic outcomes. CONCLUSIONS The surgical excision of accessory breasts with liposuction through the minimal incision is a safe and effective method to make women feel comfortable in clinical manifestations and be satisfied with their cosmetic axillar line. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Singal R, Mehta SK, Bala J, Zaman M, Mittal A, Gupta G, Rudra S, Singal S. A Study of Evaluation and Management of Rare Congenital Breast Diseases. J Clin Diagn Res 2016; 10:PC18-PC24. [PMID: 27891392 DOI: 10.7860/jcdr/2016/21077.8648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 09/16/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Polymastia and polythelia may be asymptomatic or cause pain, restriction of arm movement, milk discharge, cosmetic problems or anxiety. Cosmesis is the main indication for surgical excision of accessory breasts in axilla. In addition it also confirms the diagnosis and allays the patient's fear of harbouring a malignancy. AIM To evaluate the presentation of symptoms, investigations required for diagnosis and the management to improve the treatment protocols in patients with breast diseases. MATERIALS AND METHODS This retrospective study on breast diseases presenting as supernumerary breasts and nipples was conducted in the Department of Surgery between January 2013 and January 2016 at MMIMS Research and hospital, Mullana, Ambala. Patients were evaluated for breast diseases, either benign or malignant in both genders. A total of 32 cases diagnosed as accessory breasts disease were retrieved from the hospital archive. The clinical and radiological evaluation was done in the form of ultrasound and mammography wherever necessary. Accessory breast tissues were excised under general anesthesia and histopathological examinations were done. RESULTS Out of 32 cases: 1(3.125%) male patient had unilateral and 1(3.125%) male had bilateral accessory nipple, 7 (21.87%) females had unilateral and 1(3.125%) had bilateral accessory nipple, 1 (3.125%) diagnosed as accessory axillary fibroadenoma in female, 16(50%) presented as unilateral and 5 (15.62%) had bilateral swelling in the axilla as accessory breast. Patients underwent surgical excision and in 8(25%) cases z- shaped incision was made in view of better cosmesis. Patients were followed up upto 6 months postoperatively. There were no residual swelling and movements of the arm over the shoulder joint were normal. In 3(9.37%) cases, wound dehiscence occurred; in 2 (6.25%) cases lymphoedema formation was seen. These were successfully managed conservatively. CONCLUSION As breast swellings either fibroadenoma or carcinoma are common entities to come across everywhere but accessory breasts are rarely encountered especially in rural areas because of less awareness. The study found that there was tendency to neglect the swelling as there were minimal symptoms present. We also came across a rare entity, accessory breast and accessory nipples. A clinician should not ignore such cases taking as simple swelling because of chances of discovering a malignancy can occur.
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Affiliation(s)
- Rikki Singal
- Professor, Department of Surgery, M.M. Institute of Medical Sciences and Research , Mullana, Ambala, Haryana, India
| | - Sudhir Kumar Mehta
- Associate Professor, Department of Surgery, M.M. Institute of Medical Sciences and Research , Mullana, Ambala, Haryana, India
| | - Jyoti Bala
- Professor, Department of Patholgy, M.M. Institute of Medical Sciences and Research , Mullana, Ambala, Haryana, India
| | - Muzzafar Zaman
- Assistant Professor, Department of Surgery, M.M. Institute of Medical Sciences and Research , Mullana, Ambala, Haryana, India
| | - Amit Mittal
- Professor and Head, Department of Radiodiagnosis and Imaging, M.M. Institute of Medical Sciences and Research , Mullana, Ambala, Haryana, India
| | - Guarav Gupta
- Head of the Department, Department of Surgery, M.M. Institute of Medical Sciences and Research , Mullana, Ambala, Haryana, India
| | - Samer Rudra
- Head of the Department, Department of Gynaecology and Obstrectics, M.M. Institute of Medical Sciences and Research , Mullana, Ambala, Haryana, India
| | - Samita Singal
- Assistant Professor, Department of Radiodiagnosis and Imaging, M.M. Institute of Medical Sciences and Research , Mullana, Ambala, Haryana, India
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