Lipoma in the Accessory Axillary Breast

Abstract

The authors recently published a case report describing a patient with bilateral accessory axillary breast tissue treated using liposuction and excision [1]. We treated a similar case of monolateral axillary breast tissue. The patient was admitted to our department with a 4 · 5-cm tumor in the left axillary region. Because the lesion resembled a lipoma, it was surgically excised with the patient under general anesthesia. The histopathologic examination described only physiologic breast adenomatous tissue. Accessory breasts achieve different sizes. They are relatively common in the population (2–6%) [2, 3]. In most cases, accessory breasts are asymptomatic and cause nothing more than a visible distention, which may resemble a tumor. Surgical excision is the treatment of choice due to the risk of the same pathologic changes developing as in the normal breast. Histopathologic examination is ubiquitous for ascertaining the definite diagnosis. Ectopic breast tissue is at risk for benign and malignant breast tumors, with reported diagnoses of mastitis, fibroadenoma, and carcinoma. In this case, we treated a 51year-old woman who was asymptomatic until her second pregnancy (2005), when monolateral masses appeared in the axillae and began to increase in size (Fig. 1). Accessory breasts usually occur along the ‘‘milk line’’ [4], which develops in the 11th week of intrauterine life and extends on the anterior aspect of the body from the axillary fossa to the groin. At 1 year after parturition, a clear fluid was continuously secreted through a few small pores in the skin. Excision with histologic examination confirmed the diagnosis of lipoma. Contralateral breast tissue is characterized by small skin disease with no secretions (Fig. 2). However, a collegial discussion with our pathologist and an analysis of the literature data suggested en bloc removal for a more precise analysis not only of cellular but also of histologic characteristics of suspected mammary ducts [5, 6, 7]. The authors realized that incision scars (2.5 cm) present in the axillary pyramid often are unseen during a patient’s normal movements. This, despite a minor aesthetic incision, gives the advantage of complete histologic analysis. The authors did not use liposuction in this case, because the lipoma (4 · 5 cm) was larger than tumors treated previously, and the scar result has been good.