ACCESSORY BREAST TISSUE WITH COEXISTENT ADNEXAL TUMOR IN MALE – RARE CASE

Accessory breast tissue occurs due to failure of resolution of embryonic mammary ridges present from axilla to groin bilaterally. It may be functional or non-functional. This condition is more commonly seen in the females and very few cases have been reported in males. Development of ectopic breast tissue is dependent on hormonal stimulation similar to normal breast.It remains asymptomatic usually and increases in size after a hormonal stimulation at the time or after puberty. Majority of the occurrences are completely benign, but this condition also has the potential to convert into a malignant lesion. Apocrine hidrocystoma is regarded as cystic retention and adenomatous proliferation of apocrine sweat glands. It commonly occurs on the head & neck, but can infrequently be present in other locations like axilla, vulva, penis. This is the report of case of apocrine hidrocystoma with accessory breast tissue in a 30 year old male presented with left axillary swelling. Cytomorphological assessment revealed benign epithelial lesion and a diagnosis was established only after a histopathological examination. It emphasises the role of histopathology in diagnosis of axillary breast lesions

Fibroadenoma in axillary accessory breast: a case report

The mass are among the possible alterations observed in the axilla. When found, the most frequent differential diagnosis are lymphadenopathy, metastatic lymphadenomegaly, lymphoma, lipoma or tumors in the apocrine glands. Besides that, the presence of accessory breast tissue must also be considered and, as the topical breast tissue, can be the target of breast diseases, either benign or malignant. Female patient, 23 years old, with the presence of hardened palpable node in the right axilla. At the ultrasound, it presented characteristics that classified it as Bi-Rads® 4. An aspiration biopsy of the node was performed with fine-needle, which resulted in unsatisfying material. After the explanation of the therapeutic choices, the patient opted for the excision of the axillary node. The anatomical pathological result showed a nodular formation compatible with fibroadenoma. The occurrence of a node in the axillary region is common. However, in the vast majority of times, it is merely an inflammatory response, manifested as a lymphadenomegaly. In case of chronic mass with suspicious characteristics, it is convenient to suspect the presence of lymphoid neoplasms, locoregional metastasis of breast cancer or melanoma and alterations in accessory breast tissue. In young patients, it is important to evaluate the existence of accessory breast tissue with the presence of suspicious axillary node, because, although controversial, some authors believe that such alterations occur more frequently in these patients. Additionally, in cases of inconclusive imaging, an excision of the lesion must be performed for a definite diagnosis.

Large axillary accessory breast hamartoma: a rare entity

Hamartomas are uncommon benign tumours of axilla and breast. They show varied imaging appearances depending upon the proportion of various tissue elements present. The mammographic, ultrasound and elastographic appearances of a case of left axillary hamartoma is described in a 49 years old Indian patient.

Simultaneous preaxillary mound correction using liposuction through a breast augmentation incision

The preaxillary mound (PAM) is an aesthetic unit that is often overlooked in breast surgery, although it is intimately associated with the outcomes of breast augmentation. Over 18 months, a series of 76 patients who underwent simultaneous PAM correction using liposuction through a breast augmentation incision were reviewed retrospectively to evaluate the effectiveness of this approach. The mean follow-up was 9 months. In total, 150 PAMs were treated with suction alone. The inframammary approach was used in 72 cases, and the periareolar approach was used in four cases. Satisfactory results were achieved in 99% of cases. One patient presented postoperatively with remaining tissue. The use of a breast augmentation incision to treat PAM is an effective and safe technique that eliminates the need for an additional suction cannula incision.

Accessory breast cancer: A case report and literature review / 吉林大学学报(医学版)

Objective: To analyze the clinical pathological features of one patient with accessory breast cancer (ABC), and to explore the diagnosis, treatment, operation methods and prognosis of ABC patient. Methods: The patient received right axillary tumor resection, right axillary accessory breast resection and axillary lymph node dissection, didn't receive resection of breast in the affected side. According to the intraoperative frozen pathological diagnosis, the clinical diagnosis was ABC. After operation, the patient was treated with 8 cycles of AC-T regimen adjuvant chemotherapy (The first four cycles were given pirarubicin 60 mg · m-2, cyclophosphamide 600 mg · m-2 per cycle; the last four cycles were given docetaxel 100 mg · m-2 per cycle; every three weeks was a cycle of treatment), radiation therapy (The radiation dose was 50 Gy/25 f in the upper and lower part of the right collarbone and the tumor bed area, and after retract the tumor bed area was increased to 60 Gy) and endocrine therapy (Tamoxifen was administered at 20 mg per day). Results: The patient's breast color ultrasound and mammogram examination indicated that the right axillary mass of the patient was more likely to be malignant. The clinical diagnosis was right axillary ABC. According to the NCCN guide, the patient was treated with the standardized comprehensive treatment based on surgical treatment. 16 months after operation, the patient recovered well and had a normal life. There was no upper limb dysfunction and no lateral upper limb lymphedema, and there were no recurrence or metastasis Conclusion: ABC is extremely rarely seen in clinical practice. The clinical pathological features and treatment of ABC are similar to breast cancer. If there is no lesion in the mammary gland, it is not necessary to remove the mammary gland in the affected side.

Accessory breast cancer:A case report and literature review / 吉林大学学报(医学版)

Objective:To analyze the clinical pathological features of one patient with accessory breast cancer (ABC),and to explore the diagnosis,treatment,operation methods and prognosis of ABC patient.Methods:The patient received right axillary tumor resection,right axillary accessory breast resection and axillary lymph node dissection,didn't receive resection of breast in the affected side.According to the intraoperative frozen pathological diagnosis,the clinical diagnosis was ABC.After operation,the patient was treated with 8 cycles of AC-T regimen adjuvant chemotherapy(The first four cycles were given pirarubicin 60 mg·m-2,cyclophosphamide 600 mg·m-2 per cycle;the last four cycles were given docetaxel 100 mg·m-2per cycle;every three weeks was a cycle of treatment),radiation therapy(The radiation dose was 50 Gy/25 f in the upper and lower part of the right collarbone and the tumor bed area,and after retract the tumor bed area was increased to 60 Gy)and endocrine therapy(Tamoxifen was administered at 20 mg per day).Results:The patient's breast color ultrasound and mammogram examination indicated that the right axillary mass of the patient was more likely to be malignant.The clinical diagnosis was right axillary ABC.According to the NCCN guide,the patient was treated with the standardized comprehensive treatment based on surgical treatment.16 months after operation,the patient recovered well and had a normal life.There was no upper limb dysfunction and no lateral upper limb lymphedema,and there were no recurrence or metastasis.Conclusion:ABC is extremely rarely seen in clinical practice.The clinical pathological features and treatment of ABC are similar to breast cancer.If there is no lesion in the mammary gland, it is not necessary to remove the mammary gland in the affected side.

One male case with accessory breast / 中华整形外科杂志

To introduce the diagnosis and treatment of one male case with accessory breast. The patient was a 27-year-old male. An additional nipple on the left posterior axillary line was found on birth, which enlarged and became darken since adolescence. The clinical diagnosis was accessory breast, and a complete surgical excision was performed. Pathological examination proved the diagnosis of accessory breast.

Cáncer en mama axilar: revisión de la literatura a propósito de un caso / Axillary breast cancer: clinical case and literature review

El tejido mamario ectópico se desarrolla debido a la involución incompleta de la cresta mamaria, de localización más frecuente en la axila y más común en mujeres. Este tejido sufre cambios fisiopatológicos similares a los de la mama normal, entre los cuales se encuentra la malignización. El carcinoma primario de este tejido es infrecuente, y su manifestación más común es la masa palpable. Al igual que en la mama normal, la histología más frecuente del cáncer de mama ectópica es el Carcinoma Ductal Infiltrante y, por su localización atípica, suele diagnosticarse tardíamente, y tendría un curso más agresivo y de peor pronóstico, dado por la mayor cercanía a ganglios, piel y pared torácica. Debido a los pocos datos publicados, el diagnóstico y tratamiento no están bien establecidos, pero los esquemas disponibles son similares a los utilizados en el cáncer de mama normal. Se presenta el caso de una paciente de 41 años, con diagnóstico de cáncer de mama ectópica en la región axilar derecha, sin invasión a distancia, tratada con cirugía, quimioterapia y radioterapia, que evoluciona favorablemente, sin metástasis ni recidivas durante seguimiento.

Ectopic mammary tissue develops due to the incomplete involution of the mammary crest, which is more frequently located in the axilla and more common in women. This tissue undergoes pathophysiological changes similar to those of the normal breast, among which malignancy is found. The primary carcinoma of this tissue is infrequent and its most common manifestation is the palpable mass. As in the normal breast, the most frequent histology of ectopic breast cancer is the Infiltrating Ductal Carcinoma and, because of its atypical location, it is usually diagnosed late and it would have a more aggressive course and a worse prognosis, due to the greater proximity to lymph nodes, skin and chest wall. Because of the few published data, the diagnosis and treatment are not well established, but the available schemes are similar to those used in normal breast cancer. We present the case of a 41yearsold female patient with a diagnosis of ectopic breast cancer in the right axillary region, without distant invasion, treated with surgery, chemotherapy and radiotherapy, whoevolves favorably, without metastasis or relapses during follow-up.

CLINICAL ANALYSIS OF ACCESSORY BREAST RESECTION WITH AXILLARY MINIDER-MATOGLYPH INCISION / 现代医院

Objective To study the curative effect of accessory breast resection with axillary minidermato-glyph incision.Methods The clinical data of 47 patients undergoing accessory breast operation in our hospital be-tween April 2010 and June 2014 were retrospectively analyzed according to different methods of operation.They were divided into two groups:26 cases with axillary minidermatoglyph incision as the observation group and 21 cases with conventional accessory breast resection as the control group.The postoperative wound healing and incidence of com-plications were then compared.All the patients were followed up for 6 months.Self-designed questionnaire of visual simulation effects were adopted and shape, local pain and upper extremity activities were evaluated by the patients. Results The two groups had no significant difference in the unilateral average operation time (p >0.05).The bleeding volume in the observation group was less than the control group, and the average length of the incision and the average hospital stay were significantly shorter than those of the control group (p<0.05).After 6 months of fol-low-up, the basic satisfaction rate of shape of patients in the observation group was 95.15%, upper extremity activi-ty reached 100%, and the rate of local painlessness was 95.15%, both higher than the control group (p<0.05). Conclusion Accessory breast resection with axillary minidermatoglyph incision has the advantages of reliable cura-tive effect, less damage, inconspicuous local scar and no significant effect on physical activity.

Fibroadenoma Arising in the Accessory Breast Tissue of Axilla / 대한피부과학회지

No abstract available.

Clinicopathological Analysis of 38 Cases of Accessory Breast Cancer / 中国肿瘤临床

Objective: To study the clinicopathological characteristics，diagnosis，multiple modality therapy and prognosis of accessory breast cancer. Methods: Clinical data of 38 patients with accessory breast cancer seen in our hospital between October 1985 and November 2007. Results: The 38 cases of accessory breast cancer accounted for 0.15% of all 26,078 breast cancer cases during the same period.Six patients of stage Ⅰ and 3 patients of stage Ⅱ underwent breast-conserving local wide excision of the tumor plus axillary lymph node dissection,with the resection margins pathologically negative.The other 9 cases of stage Ⅱ patients were treated with Auchincloss mastectomy.Stage Ⅲ and stage Ⅳ patients were treated with Auchincloss or Halsted mastectomy.The most common histological type of accessory breast cancer was infiltrating ductal Carcinoma for 18 patients(47.4%)，of which 3 cases were associated with adenoma of the nipple tube.There were 6 cases of carcinoma simplex，6 cases of intraductal Carcinoma，3 cases of adenocarcinoma with focal squamous cancer cells differentiation，3 cases of medullary carcinoma，and 2 cases of mucinous adenocarcinoma.The most common pathological stages(according to AJCC staging of breast cancer,2002.6th edition)were stage Ⅱ and Ⅲ in 12 cases(31.6%)，stage Ⅰ in 6 cases，and stage Ⅳ in 8 cases.All patients were followed-up for 1 to 23 years.The median follow-up time was 6 years and 7 months，and the follow-up rate was 100%.Until November 2008，12 patients died of metastasis and the other 26 patients were still alive.The 5-year overall survival rate was 35.3%.significantly lower than that of breast cancer patients(66.8%).The 3-year survival rate was 77.8%.The 5-year disease free survivaI rate was 28.6%and the 3-year disease free survival rate was 63.6%. Conclusion: Accessory breast cancer is rarely seen but is aggressive.The diagnosis mainly depends on clinical characteristics，postoperative pathology and imaging examinations.Early diagnosis is essential.Surgery combined with other adjuvant therapies can improve patient survival.

Diagnosis and treatment of accessory breast cancer in 16 cases / 中国综合临床

Objective To investigate the clinicopathological characteristics,diagnosis and therapy,as well as the prognosis of accessory breast cancer. Methods Twenty-two cases were diagnosed as accessory breast cancer from Jan 1,1984 to Dec 31,2008, their clinicopatholgical data were analyzed retrospectively.Results Up to Mar. 1, 2010,2 cases had local recurrence;7 cases had long-distance metastasis;6 cases died. In the current study,the 5-year survival rate of accessory breast cancer was 43. 7%. Conclusions Accessory breast cancer is aggressive. The diagnosis was mainly based on clinical characteristics and postoperative pathology. The combined therapies may improve the survival rate.

Comparison between Liposuction and Open Surgery for Accessory Breast / 中国微创外科杂志

Objective To compare the efficacy of liposuction and open surgery for patients with accessory breast.MethodsA total of 73 patients with accessory breast,who were treated in our hospital from June 2000 to December 2007,were enrolled in this study and divided into open surgery(June 2000 to June 2004,43 patients with accessory breast at 80 sides)and liposuction(April 2004 to December 2007,30 cases with accessory breast at 58 sides)groups.The outcomes of the patients,operation time,and intraoperative blood loss in the two groups were compared.Results The curative rate of the both groups were 100%.However,the open surgery group had more blood loss [(49.6?13.3)ml vs(28.9?6.9)ml,t=10.836,P=0.000] and longer operation time[(57.4?11.1)min vs(27.3?4.3)min,t=19.597,P=0.000].Conclusions Compared with open surgery,liposuction leads to quicker recovery and less trauma without leaving scars,and thus is more acceptable to the patients.

Clinical experience of totally endoscopic resection of axillary accessory breast / 中国微创外科杂志

Objective To study the clinical feasibility and effect of totally endoscopic resection of axillary accessory breast.Methods Totally endoscopic resection of axillary accessory breast was performed in 48 cases(59 sites).On the basis of liposuction,a camera port and two 5-mm working trocars were made.By using forceps,dissecting scissors,or harmonic knife,were inserted.The cobweb-like fibropartition around the accessory breast was dissected.Results Postoperatively,there were 1 case of subcutaneous liquid accumulation and 2 cases of subcutaneous petechia,and no hematoma or infection developed.All wounds healed by first intention.Follow-up observations for 2～58 months(mean,23.6 months) showed good appearance and satisfactory effects.Conclusions Totally endoscopic resection of axillary accessory breast is safe,offering good cosmetic effects and being worthy of recommendation.

Treatment of Accessory Breast Utilizing Ultrasound- Assisted Liposuction

Accessory breasts are normal variants of embryological development that may initially become prominent at puberty or during pregnancy. One of the most common sites is the axilla. Various methods including simple excision, diamond shaped excision and Y-V technique were introduced to correct appearance of the accessory breast. But, it may cause the unsightly scar, contracture, hypertrophic scar, keloid, hematoma, paresthesia, delayed wound healing, wound infection. The authors treated 10 patients of 13 accessory breasts by combined methods using simultaneous external(Exonix(r), Snowden Pencer, USA) and internal(Contour Genesis system(r), Mentor, USA) ultrasound assisted liposuction from May 2000 to December 2002 with mean follow-up period of 8 months. The results of our studies are as follows; the volume of aspirates ranged from 50 to 100 cc per breast. There were no major complications such as skin flap necrosis or hematoma. All the patients were satisfied with the results. In total 10 patients, 6 patients(60.0%) were very satisfied, and 4 patients(40.0%) were satisfied. There were no wound problem and remarkable scar. The final shape was natural and satisfactory for patients and doctors. As a result, we have obtained excellent results in the accessory breast treatment by combined method using external and internal Ultrasound Assisted Liposuction.

A Case of Fibroadenoma Arising in the Accessory Breast Tissue of the Axilla / 대한피부과학회지

Accessory breast tissue of the axilla is one of the varieties of supernumerary breast tissue, which is observed after puberty. The tissue is capable of developing identical pathophysiologic changes as normal breast tissue. The pathologic findings of the accessory breast tissue were classified as normal breast tissue, cystic disease, chronic mastitis, atypical ductal hyperplasia, and fibroadenoma. Among these, the fibroadenoma is relatively uncommon. We have experienced a case of fibroadenoma arising in the accessory breast tissue of the axilla. A 28-year-old woman had a 8-month history of 1.5x1.3cm and 1.1x1.2cm sized firm nodules, deeply located in subcutaneous tissue on the left axilla. The size of the lesion was constant. However, she complained of mild tenderness at every premenstrual period. The histopathologic finding of the lesion revealed the typical features of fibroadenoma with accessory breast tissue.

Invasive Ductal Carcinoma Arising from Axillary Accessory Breast / 한국유방암학회지

As a consequence of the incomplete resolution of embryologic mammary ridges, ectopic breast tissue can be present anywhere along the "milk line", including the axillary region. Aberrant breast tissue can develop with any disease that affects the normal breast, including a breast carcinoma. A carcinoma of aberrant breast tissue is rare, but should still be investigated and treated properly with respect to other breast cancers in the embryonic milk-line. Herein is reported our recent experience of a carcinoma originating from aberrant breast tissue in the right axilla. An abnormal nodule around the periphery of the normal breast should be suspected as a breast carcinoma and differential diagnosis and properly treated.

Accessory Breast Tissue Clinically Mimicking Soft Fibroma / 대한피부과학회지

Accessory breast tissue is a developmental anomaly defined as persistence of breast tissue along the embryonic mammary line in the mid-thoracic region. Rarely, an abnormally located remnant of the line persists and develops into completely formed mammary glands. A 61-year-old woman presented with a pedunculated mass on the mid-lower abdomen, below the umbilicus. She detected a pea-sized nodule a few decades ago and it gradually enlarged since 1 year ago. There was no pigmented prominence resembling a nipple. Histological finding revealed lobules of the breast forming islands of glandular tissue. We believe this is an unusual case of accessory breast tissue mimicking soft fibroma as a pedunculated mass.

A Clinical Study of Accessory Breast Tissue in Axillae

Accessory axillary breast tissue has received little attention in the surgical literature although it is not an uncommon kind of aberrant breast tissue. Twenty-six patients who have been treated with an exicision of accessory breast tissue from January 1988 to June 1995 at the Department of Surgery, College of Medicine, Soonchunhyang University were analyzed retrospectively. The age of the patients ranged from 18 to 58 years, median age, 34 years. All were female including two postmenopausal females. We observed a palpable mass in the left axillae in 6 patients, in the right axillae in 8 patients and in the both axilla in 12 patients. Of the 41 masses of 26 patients, 19 masses were located on tne anterior axillary line, 20 masses on the midlle axillary line and 2 masses on the posterior axillary line. The size of the accessory breast tissue ranged from 0.5 to 8cm, with a median of 3.4cm. The presenting symptoms were mass in all cases, pain in 12 cases, growing mass in 4 cases and redness in one case. Histological diagnosis of total 41 masses revealed 28 normal breast tissue, 9 fibrocystic disease, 1 ductal ectasia, 1 fibroadenoma, 1 fibrocystic disease with ductal ectasia and 1 infiltrating ductal carcinoma. There were no typical clinical characteristics for differential diagnosis preoperatively. Of a total of 38 excisional operations, 4 complications developed (two hematoma, one wound infection and one skin tag). The postoperative hospital stay ranged from 1 to 17 days. The accessory breast tissue might be regarded as a more important disease than before, because various pathologic changes could occur in it including malignant change. Early diagnosis and correct excision are usually recommended.