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Barrios M, Perez NE, Briski LM, Pluguez-Turull C. Recurrent ectopic primary breast adenocarcinoma of the vulva with a 19-year follow-up period. BMJ Case Rep 2024; 17:e257791. [PMID: 38367988 PMCID: PMC10875544 DOI: 10.1136/bcr-2023-257791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2024] Open
Abstract
We present a case of an ectopic breast adenocarcinoma of the vulva with metastatic local recurrence and a total follow-up period of 19 years, the longest documented in the literature to our knowledge. Following surgical excision, radiation therapy and hormonal treatment after the recurrence, the patient has remained disease free. This case demonstrates the potential for malignant transformation in accessory breast tissue and highlights the importance of close surveillance and regular physical examinations in patients with a history of ectopic breast malignancy.
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Affiliation(s)
- Mirelys Barrios
- Department of Radiology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Nathalie E Perez
- University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Laurence M Briski
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Cedric Pluguez-Turull
- Department of Radiology, University of Miami Miller School of Medicine, Miami, Florida, USA
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2
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Bataraga E, Matuzala A, Eisendle K. Accessory axillar breast tissue-Newest member of BLEND TAN EGG family-BLEND TAN EGG MA. J Eur Acad Dermatol Venereol 2023; 37:e1412-e1413. [PMID: 37458531 DOI: 10.1111/jdv.19342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/12/2023] [Indexed: 07/25/2023]
Affiliation(s)
- Elga Bataraga
- Department of Dermatology and Venereology, Rīga Stradiņš University, Rīga, Latvia
| | | | - Klaus Eisendle
- Department of Dermatology and Venereology, Rīga Stradiņš University, Rīga, Latvia
- Department of Dermatology and Venerology, Central Teaching Hospital Bolzano/Bozen, Bolzano, Italy
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3
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Sperduto W, McCullough A, Northfelt D, McGee L, Pockaj B, Jogerst K. Implications of a Supernumerary Nipple Breast Cancer in a BReast CAncer Sequence Variation Carrier: A Case Report. Mayo Clin Proc Innov Qual Outcomes 2023; 7:437-442. [PMID: 37752967 PMCID: PMC10518438 DOI: 10.1016/j.mayocpiqo.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023] Open
Abstract
Supernumerary nipples develop on the chest and abdominopelvic regions along the embryonic milk line. Their anatomy varies from isolated accessory nipples to complete supernumerary nipples (accessory nipple, areola, and underlying glandular breast tissue). Patients with a pathogenic BReast CAncer (BRCA) sequence variation are at an increased cumulative risk of developing breast cancer, and it is the standard of care for them to be offered medical or surgical risk reduction. Given the relatively low prevalence of breast cancer within supernumerary nipples and ectopic glandular breast tissue, no current recommendations exist to guide multidisciplinary management of patients with BRCA sequence variations and ectopic breast tissue. Our case is of a 62-year-old female BRCA-1 carrier with a previous history of right breast cancer who developed a new primary breast cancer within a supernumerary nipple after undergoing surgical risk reduction. With no current consensus on the surgical management of supernumerary nipples in BRCA-1 carriers, our recommendation is to perform a thorough physical examination before risk-reducing operation. If supernumerary nipples or ectopic glandular breast tissue are present, wide-local excision of the tissue should be offered for more complete surgical risk reduction.
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Affiliation(s)
- Will Sperduto
- Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ
| | | | - Donald Northfelt
- Department of Medicine, Division of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ
| | - Lisa McGee
- Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ
| | | | - Kristen Jogerst
- Department of Surgery, Mayo Clinic, Phoenix, AZ
- Department of Surgery, Massachusetts General Hospital, Boston
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4
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Achouri L, Jellali A, Henchiri H, Boukhris S, Zaaimi Y, Mansouri H, Mahjoub N. Primary ectopic breast carcinoma: a case report. J Med Case Rep 2022; 16:443. [PMID: 36434655 PMCID: PMC9700870 DOI: 10.1186/s13256-022-03670-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/07/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Ectopic breast tissue is present in 2-6% of women. Ectopic mammary tissue can experience physiological changes and the same pathological processes as the eutopic breast. Ectopic breast cancer represents an uncommon condition accounting for 0.3% of all breast neoplasms, and it is most frequently located in the axilla. CASE REPORT We report a rare case of a 57-year-old Tunisian woman who presented with a left-sided axillary mass evolving for about 1 month. The axillary ectopic breast tissue containing the mass was excised with axillary dissection. Pathology revealed a medullary multifocal carcinoma and metastasis was detected in two lymph nodes. She had local radiotherapy after six cycles of chemotherapy. She received herceptin therapy and hormonotherapy. After a 2-year follow-up, no evidence of local recurrence or distant metastases have been identified. CONCLUSION Ectopic breast carcinoma is a rare entity that should be the first diagnosis to be considered if an axillary lump is present in ectopic breast tissue. No particular guidelines on diagnosis and treatment are available. Therefore, physicians should be aware of this condition to avoid treatment delays. Once diagnosed, careful patient follow-up is essential because of the ambiguous natural history of this rare entity.
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Affiliation(s)
- Leila Achouri
- Department of Surgical Oncology, Regional Hospital of Jendouba, Jendouba, Tunisia ,Faculty of Medicine of Tunis, Tunis Elmanar University, Tunis, Tunisia
| | - Amani Jellali
- Faculty of Medicine of Tunis, Tunis Elmanar University, Tunis, Tunisia ,Department of Surgical Oncology, Salah Azaïz Institute of Cancer, Tunis, Tunisia
| | - Houda Henchiri
- Department of Surgical Oncology, Regional Hospital of Jendouba, Jendouba, Tunisia
| | - Sabrine Boukhris
- Department of Surgical Oncology, Regional Hospital of Jendouba, Jendouba, Tunisia ,Faculty of Medicine of Tunis, Tunis Elmanar University, Tunis, Tunisia
| | - Yosra Zaaimi
- Faculty of Medicine of Tunis, Tunis Elmanar University, Tunis, Tunisia ,Department of Gastroenterology, Charles Nicole Hospital, Tunis, Tunisia
| | - Houyem Mansouri
- Department of Surgical Oncology, Regional Hospital of Jendouba, Jendouba, Tunisia ,Faculty of Medicine of Tunis, Tunis Elmanar University, Tunis, Tunisia
| | - Najet Mahjoub
- Department of Surgical Oncology, Regional Hospital of Jendouba, Jendouba, Tunisia ,Faculty of Medicine of Tunis, Tunis Elmanar University, Tunis, Tunisia
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5
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Katoof FM, jasim HA. Rare findings in ectopic breast tissue: A case study of 7 patients. INTERNATIONAL JOURNAL OF SURGERY OPEN 2022. [DOI: 10.1016/j.ijso.2022.100572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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6
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Sapon-Cousineau S, Moldoveanu D, Charpentier D, Gagnon A, Patocskai É. Locally advanced breast cancer arising in the axilla. J Surg Case Rep 2022; 2022:rjac425. [PMID: 36131807 PMCID: PMC9486583 DOI: 10.1093/jscr/rjac425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/25/2022] [Indexed: 11/12/2022] Open
Abstract
Locally advanced breast cancer arising from ectopic axillary breast tissue is an unusual presentation of this malignancy. The work-up and treatment approach pose some unique challenges. We present the case of a 37-year-old female presenting with a left axillary lesion with skin involvement. Radiological studies and biopsy demonstrated an underlying axillary mass compatible with a triple-positive invasive ductal carcinoma of the breast. Following neoadjuvant therapy, the patient underwent nipple-sparing mastectomy with wide local excision of the involved axillary skin and axillary lymph node dissection. Ectopic locally advanced breast cancer can be treated similarly to its orthotopic counterpart, favoring a neoadjuvant therapy approach followed by surgical excision. Special considerations include the local anatomy of the tumor, the extent of surgery and reconstructive options.
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Affiliation(s)
| | | | | | - Alain Gagnon
- Centre Hospitalier de l'Université de Montréal , Montréal, QC , Canada
| | - Érica Patocskai
- Centre Hospitalier de l'Université de Montréal , Montréal, QC , Canada
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7
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Kim H, Ko EY, Han BK, Kim JY, Chae BJ, Lee H. Multicentric Breast Cancer of the Axillary and Pectoral Breasts: A Case Report and Literature Review. J Breast Cancer 2022; 25:436-442. [PMID: 35914750 PMCID: PMC9629964 DOI: 10.4048/jbc.2022.25.e33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 06/23/2022] [Accepted: 07/05/2022] [Indexed: 11/30/2022] Open
Abstract
Multicentric cancer of the pectoral and ectopic breasts is extremely rare, and diagnosing this malignancy remains challenging because axillary breast cancer is easily misdiagnosed as lymph node metastasis. Moreover, there are no established treatment guidelines for this disease. We present our experience with a multicentric breast cancer patient who showed different responses to neoadjuvant chemotherapy (NAC) and underwent surgical treatments that differed from those in previous studies. In our case, the preoperative imaging of both lesions and subsequent core needle biopsy of each lesion were crucial, as these procedures confirm the diagnosis and help decide the chemotherapy regimen based on the subtype. After NAC, the patient underwent right breast-conserving surgery, sentinel lymph node biopsy (SLNB), and excision of accessory breast tissue in the right axilla. SLNB should be the initial step in staging multicentric breast cancer, unless imaging scan shows evidence of lymph node metastasis.
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Affiliation(s)
- Harim Kim
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Young Ko
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. mailto:
| | - Boo-Kyung Han
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji-Yeon Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byung Joo Chae
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyunwoo Lee
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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8
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Marques-Antunes J, Cardoso F, Santos T, Nora M, Scigliano H. Invasive Lobular Carcinoma Arising in Ectopic Breast Tissue: A Case Report. Cureus 2022; 14:e24055. [PMID: 35573574 PMCID: PMC9097936 DOI: 10.7759/cureus.24055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2022] [Indexed: 11/23/2022] Open
Abstract
Incomplete regression of the embryonic mammary line occurs in 0.3-6% of the population. Ectopic breast tissue is mostly asymptomatic and can undergo malignant transformation. Ectopic breast cancer accounts for 0.2-0.6% of all breast cancers. Screening breast examinations can miss these lesions due to their location making the diagnosis more challenging. We describe a case of a primary invasive lobular carcinoma in an ectopic breast on the left axilla detected in a 49-year-old woman. Firstly diagnosed as a sebaceous cyst, the lesion was excised under local anesthesia. Histopathology showed breast tissue widely infiltrated by an invasive carcinoma. Excision of the remnant tissue with axillary lymph node dissection was performed. Ectopic breast carcinoma is a rare diagnosis and there is a general lack of awareness. The presence of an abnormal mass along the mammary ridge should raise clinicians’ attention. Management of primary ectopic breast carcinoma should be based on a multidisciplinary approach under the same principles as breast cancer. Furthermore, it does not appear to bring a worse prognosis when diagnosed at similar disease stages.
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9
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Wu J, Chen H, Dong J, Cao Y, Li W, Zhang F, Zeng X. Axillary masses as clinical manifestations of male sweat gland carcinoma associated with extramammary Paget’s disease and accessory breast carcinoma: two cases report and literature review. World J Surg Oncol 2022; 20:109. [PMID: 35379255 PMCID: PMC8978366 DOI: 10.1186/s12957-022-02570-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 03/21/2022] [Indexed: 11/17/2022] Open
Abstract
Background Male cases of accessory breast carcinoma and sweat gland carcinoma associated with extramammary Paget’s disease of the axilla are uncommon. In clinical diagnosis and treatment, it is necessary to determine the disease carefully and make a reasonable treatment strategy according to the patient’s situation. Case presentation We described two male cases of the special tumor with an axillary mass as the first clinical symptom, one of which was diagnosed as accessory breast cancer and the other as sweat gland cancer associated with extramammary Paget’s disease. We treated the two diseases individually in the hopes of providing a reference for the diagnosis and management of diseases with axillary nodules as the initial symptom. Conclusions The reports of these two cases can provide reference and corresponding thinking for clinical differentiation of axillary lymphadenopathy caused by different causes and subsequent treatment. These two cases may further enrich the database of rare cases and provide some ideas for the treatment of axillary lymphadenopathy caused by different causes.
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10
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Sghaier S, GHalleb M, Marghli I, Bouida A, Ben Hassouna J, Chargui R, Rahal K. Primary ectopic axillary breast cancer: a case series. J Med Case Rep 2021; 15:412. [PMID: 34330331 PMCID: PMC8325209 DOI: 10.1186/s13256-021-02998-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 06/29/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Ectopic breast tissue is present in 2-6% of women. Ectopic breast cancer represents an uncommon disease accounting for about 0.3% of all breast neoplasms, limiting the available evidence. Thus, we aim to report long-term outcomes in five cases treated at our institution. CASE SERIES Our Tunisian patients' median age was 48 years (33-60 years), and the median follow-up was 8 years (4-10 years). The ectopic breast tissue was located four times in the right axilla. The median tumor size was 25 mm (15-55 mm). Four of the patients underwent a wide local excision and axillary lymph node dissection. Three of those women had positive lymph nodes; thus, they received adjuvant chemotherapy, radiation therapy, and hormone therapy. The patient with a negative lymph node (case 5) had adjuvant radiation therapy and hormonal therapy. One of the patients (case 1) had a positive supraclavicular lymph node and received radiation therapy, chemotherapy, and hormonal therapy. The latter developed a locoregional relapse after 4 years and was treated with mastectomy and chemotherapy. One patient (case 4) had a distant metastasis after 2 years of follow-up and received chemotherapy. The three other patients were free of relapse during their follow-up period. CONCLUSION Primary axillary breast carcinoma is a rare entity. Despite the paucity of literature, our findings and authors' recommendations suggest that local excision can be performed safely with promising outcomes in this subset of patients.
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Affiliation(s)
- S. Sghaier
- Surgical oncology department, Salah Azaiez Institute of cancer, Tunis, Tunisia
| | - M. GHalleb
- Surgical oncology department, Salah Azaiez Institute of cancer, Tunis, Tunisia
| | - I. Marghli
- Surgical oncology department, Salah Azaiez Institute of cancer, Tunis, Tunisia
| | - A. Bouida
- Surgical oncology department, Salah Azaiez Institute of cancer, Tunis, Tunisia
| | - J. Ben Hassouna
- Surgical oncology department, Salah Azaiez Institute of cancer, Tunis, Tunisia
| | - R. Chargui
- Surgical oncology department, Salah Azaiez Institute of cancer, Tunis, Tunisia
| | - K. Rahal
- Surgical oncology department, Salah Azaiez Institute of cancer, Tunis, Tunisia
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11
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Niakan S, Love H, Cao Q, Kawar N. Primary invasive lobular carcinoma arising in mammary-like glands of the vulva managed with neoadjuvant trastuzumab-based chemotherapy, excision, and sentinel lymph node biopsy. Clin Case Rep 2021; 9:118-122. [PMID: 33489145 PMCID: PMC7813003 DOI: 10.1002/ccr3.3475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/12/2020] [Indexed: 11/24/2022] Open
Abstract
A rare case of Her2/neu-positive mammary-like gland adenocarcinoma of the vulva treated with neoadjuvant therapy, trastuzumab, and achieved complete pathological response on excision, adjuvant radiation, complicated by brain metastasis recurrence.
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Affiliation(s)
- Shiva Niakan
- Department of Obstetrics and GynecologyUniversity of Massachusetts Medical School‐BaystateSpringfieldMAUSA
| | - Heather Love
- Department of Obstetrics and GynecologyUniversity of Massachusetts Medical School‐BaystateSpringfieldMAUSA
| | - Qing Cao
- Department of PathologyUniversity of Massachusetts Medical School‐BaystateSpringfieldMAUSA
| | - Nada Kawar
- Department of Obstetrics and GynecologyUniversity of Massachusetts Medical School‐BaystateSpringfieldMAUSA
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12
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Jackson J, Walker E, Bethune R, Bracey T, Mason C, Mandalia T. Extramammary Borderline Phyllodes Tumor Presenting as an Umbilical Mass. Int J Surg Pathol 2020; 29:648-652. [PMID: 33345669 DOI: 10.1177/1066896920981632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Phyllodes tumors (PTs) represent a spectrum of rare, fibroepithelial neoplasms of the breast, which can be subcategorized as benign, borderline, or malignant based on their histological appearance. Accessory breast tissue may present anywhere along the embryological mammary ridge, and at distant locations as aberrant breast tissue. We present the case of a 56-year-old lady with an umbilical mass, thought to represent a strangulated hernia. Sections showed a fibroepithelial tumor with leaf-like ducts, conspicuous mitotic activity (up to 8 per 10 high-power fields), and focal infiltration into fat. Immunohistochemical studies showed diffuse positivity of epithelial cells for estrogen receptor, mammaglobin, GCDFP-15, and CK7. These findings were consistent with a borderline PT. This is the first case report of PT presenting as an umbilical mass, and the first extramammary borderline PT described.
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13
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Sinduja R, Kumaran R, Sundaramurthi S, Krishnaraj B, Sistla SC. Carcinoma of the Accessory Axillary Breast: A Diagnostic Dilemma and a Management Challenge. Cureus 2020; 12:e11844. [PMID: 33409083 PMCID: PMC7781567 DOI: 10.7759/cureus.11844] [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] [Accepted: 12/01/2020] [Indexed: 11/21/2022] Open
Abstract
Carcinoma of the accessory axillary breast is uncommon, with an incidence of 0.2 to 0.6%. We report a patient whose biopsy of a suspicious lesion in the axilla present for one year revealed invasive ductal carcinoma (IDC). There was presence of breast tissue and absence of lymphoid tissue in the biopsy, suggesting a breast malignancy. Magnetic resonance mammography was suggestive of the lesion well away from the normal breast, confirming an accessory axillary breast. She was offered wide local excision of the lesion with axillary lymph node dissection and modified radical mastectomy (MRM), and she chose the latter. Her post-operative biopsy showed the involvement of all the 25 lymph nodes harvested. Any suspicious lesion in the axilla should be promptly worked up for malignancy. Accessory axillary breast carcinoma, if confirmed, can be addressed with wide local excision along with axillary lymph node dissection. However, further studies should clarify this and the outcomes.
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Affiliation(s)
- Ramanan Sinduja
- Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Ranjith Kumaran
- General Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | | | | | - Sarath Chandra Sistla
- Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
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14
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Singh UB, Mahajan JK, Vaiphei K. Giant Phyllodes Tumor in Ectopic Breast Tissue. J Indian Assoc Pediatr Surg 2020; 25:251-253. [PMID: 32939121 PMCID: PMC7478275 DOI: 10.4103/jiaps.jiaps_137_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 08/31/2019] [Accepted: 10/12/2019] [Indexed: 11/04/2022] Open
Abstract
Breast masses are uncommon in children and adolescents. Ectopic breast tissue is further uncommon and may be present in locations such as the face, back, and thigh. A 12-year-old female child presented with a hard, nonmobile lump in the right breast. On exploration by submammary incision, the lump was found to be below the pectoralis major muscle and had no communication with the overlying orthotopic breast tissue. Histopathological examination revealed a well-encapsulated biphasic lesion, with features characteristic of a phyllodes tumor. We report a hitherto unreported case of aberrant breast tissue lying under the pectoralis muscle and containing phyllodes tumor.
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Affiliation(s)
- Umesh Bahadur Singh
- Department of Pediatric Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Jai K Mahajan
- Department of Pediatric Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kim Vaiphei
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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15
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Mandal S, Bethala MG, Dadeboyina C, Khadka S, Kasireddy V. A Rare Presentation of an Invasive Ductal Carcinoma of Ectopic Axillary Breast Tissue. Cureus 2020; 12:e9928. [PMID: 32968589 PMCID: PMC7505611 DOI: 10.7759/cureus.9928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Ectopic breast tissue (EBT) is a rare entity and can present anywhere along the milk line, including the axilla, inframammary region, thighs, perineum, groin, and vulva. However, the axilla is the most common area of presentation. EBT can present as supernumerary breasts or aberrant breast tissue. Malignancy arising in EBT is rare, but the most common morphological variant is invasive ductal carcinoma. We report a case of a 43-year-old woman, a smoker with a family history of breast cancer, who presented to our clinic with a small mass in the right axillary area. After monitoring it for one year, the mass increased in size, so she returned to the clinic and decided with her care team to excise the mass. Histopathology showed invasive mammary adenocarcinoma arising in EBT and was diagnosed as right accessory stage I breast cancer. This case illustrates the imperative that any mass in the axillary region should be thoroughly assessed to rule out carcinoma in the accessory axillary tissue for timely management.
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Affiliation(s)
- Shobha Mandal
- Internal Medicine, Guthrie Robert Packer Hospital, Sayre, USA
| | | | | | - Sushmita Khadka
- Internal Medicine, Guthrie Robert Packer Hospital, Sayre, USA
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16
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Botty Van den Bruele A, Gemignani ML. Management of ipsilateral supernumerary nipple at time of breast cancer diagnosis. Breast J 2020; 26:2042-2044. [PMID: 32729645 DOI: 10.1111/tbj.13973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/16/2020] [Accepted: 06/23/2020] [Indexed: 11/28/2022]
Abstract
Supernumerary breast components occur predominantly between the breast and umbilicus. Carcinoma of this ectopic, or accessory breast tissue (ABT), is exceedingly rare, accounting for <1% of breast cancer cases. Historically, ectopic breast carcinoma was considered aggressive with poor outcome. In 1995, Evans et al reported 90 cases spanning from 1929 to 1993 with a 9.4% survival beyond 4 years. More contemporary studies reveal improvement in both treatment and survival. There is currently no consensus on whether prophylactic excision of an ipsilateral supernumerary nipple at the time of initial breast cancer diagnosis is necessary. The following describes a patient with an ipsilateral tumor uniquely located within her supernumerary nipple 5 years after mastectomy.
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Affiliation(s)
| | - Mary L Gemignani
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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17
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Biffani S, Tiezzi F, Fresi P, Stella A, Minozzi G. Genetic parameters of weeping teats in Italian Saanen and Alpine dairy goats and their relationship with milk production and somatic cell score. J Dairy Sci 2020; 103:9167-9176. [PMID: 32713699 DOI: 10.3168/jds.2020-18175] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 04/14/2020] [Indexed: 01/26/2023]
Abstract
This paper reports a quantitative genetics analysis of weeping teats (WT), an abnormality of the mammary gland in goats. Weeping teats are characterized by milk oozing out of the teat or by the presence of multiple cysts near its base. This abnormality has been routinely recorded in Italian Alpine and Saanen goats since 2000 using a score of 0 or 1 (0 = defect not present, 1 = defect present). No information is available on the genetic background of WT or its relationship with production or other udder-related traits. Data obtained by the Italian National Sheep and Goat Breeders Association (Rome, Italy) were used to estimate both heritability of WT and its genetic correlation with milk yield, somatic cell score, and udder traits. The final data set used in the analysis included 2,178 Saanen and 2,309 Alpine primiparous goats kidding from 2009 to 2014. The pedigree data included 7,333 Saanen and 7,421 Alpines, respectively. A threshold-linear multivariate animal model was used to estimate variance and covariance components. A genealogical data analysis was also implemented, including genealogical data completeness, inbreeding, and identification of possible most recent common ancestors. On average, around 4 and 13% of primiparous Saanen and Alpine females kidding from 2009 to 2014 showed mammary gland abnormality, respectively. Weeping teats heritability was 0.27 and 0.26 for Saanen and Alpine, respectively. Genetic correlations between milk production or somatic cell score ranged from -0.16 in Saanen to 0.43 in Alpine, but the standard error of the estimates was very large. Positive genetic correlations were observed among WT and teat characteristics in both Saanen and Alpine. The average inbreeding of abnormality carriers was 2.4 and 5.1 for Saanen and Alpine, respectively. The genealogical data analysis identified 4 common ancestors of affected does in Saanen and 2 in Alpine. These results indicate that WT have a possible genetic background. A genome-wide association study might help in understanding the polygenic or monogenic determination of this abnormality.
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Affiliation(s)
- Stefano Biffani
- Consiglio Nazionale delle Ricerche (CNR), Istituto di Biologia e Biotecnologia Agraria (IBBA), 20133 Milano, Italy.
| | - Francesco Tiezzi
- Department of Animal Science, North Carolina State University, Raleigh 27695
| | | | - Alessandra Stella
- Consiglio Nazionale delle Ricerche (CNR), Istituto di Biologia e Biotecnologia Agraria (IBBA), 20133 Milano, Italy
| | - Giulietta Minozzi
- Department of Veterinary Medicine, University of Milan, 20133 Milan, Italy
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18
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Invasive ductal carcinoma arising from an accessory nipple. JAAD Case Rep 2020; 6:540-542. [PMID: 32490120 PMCID: PMC7256431 DOI: 10.1016/j.jdcr.2020.04.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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19
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Thasanabanchong P, Vongsaisuwon M. Unexpected presentation of accessory breast cancer presenting as a subcutaneous mass at costal ridge: a case report. J Med Case Rep 2020; 14:45. [PMID: 32234067 PMCID: PMC7110727 DOI: 10.1186/s13256-020-02366-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 03/05/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND During embryogenesis, bilateral thickening of ectoderm from anterior axillary folds to inguinal folds, called mammary ridges or milk lines, develops into breast tissues. Only a pair in the pectoral area is spared from regression and continuously develops into normal breasts. Accessory breasts can result if the regression process is incomplete. These ectopic breasts can change physiologically and pathologically similar to normal breasts. Unsurprisingly, they are capable of turning malignant. Reported cases show the most common area for accessory breast cancer to be the axillary area. We report a rare case of accessory breast cancer over the costal ridge. CASE PRESENTATION We present the case of a 51-year-old Asian woman who complained of an enlarged mass lower to her left breast developed over the period of 3 months while on contraceptive pills. Unaware that the mass could be an accessory breast, the primary doctor had prescribed oral contraceptives. After our patient had noticed that the mass was obviously growing, she decided to consult a surgeon as the mass continued to grow. Expected to be benign, the mass was investigated by ultrasonography and then excised surgically. A pathology report identified the mass to be a carcinoma of the ectopic breast tissue. However, sentinel lymph node biopsy showed no nodal metastasis of all four lymph nodes. Following surgery, she received chemotherapy, radiation, and antihormonal treatment. After 2 years of postoperative follow up, she remained free of disease. CONCLUSIONS This patient was diagnosed as having accessory breast cancer which presented with a subcutaneous mass. As this condition is exceptionally rare but curable by early treatments, we recommend surgeons to consider potential malignancy when patients present with a subcutaneous mass.
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Affiliation(s)
| | - Mawin Vongsaisuwon
- Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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20
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Aramin H, Koirala P, Shah A, Adams K, Buza N, Desai S, Fairbairn M, Goldenberg D, Gao W, Chuang L, Vidhun R, Andikyan V. Metachronous vulvar ectopic breast cancer, a case report and literature review. Gynecol Oncol Rep 2019; 30:100515. [PMID: 31867432 PMCID: PMC6890968 DOI: 10.1016/j.gore.2019.100515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/28/2019] [Accepted: 11/04/2019] [Indexed: 11/11/2022] Open
Abstract
When two or more primary tumors arise at the same time, they are considered synchronous. A metachronous tumor in a new primary that develops after an initial cancer diagnosis. The diagnosis of vulvar breast cancer is primarily histopathologic, based on morphology and immunostaining. Identifying a cancer as a metastasis versus as synchronous/metachronous significantly impacts staging and treatment.
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Affiliation(s)
- Hermineh Aramin
- Department of Pathology, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA
| | - Pratistha Koirala
- Department of Obstetrics and Gynecology, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA
| | - Abhishek Shah
- Department of Pathology, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA
| | - Kendall Adams
- Department of Obstetrics and Gynecology, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA
| | - Natalia Buza
- Department of Pathology Yale School of Medicine New Haven, CT, USA
| | - Sapna Desai
- Department of Pathology, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA
| | - Melissa Fairbairn
- Department of Gynecologic Oncology, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA
| | - David Goldenberg
- Department of Plastic Reconstructive Surgery, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA
| | - Wenli Gao
- Department of Oncology, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA
| | - Linus Chuang
- Department of Obstetrics and Gynecology, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA.,Department of Gynecologic Oncology, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA
| | - Ramapriya Vidhun
- Department of Pathology, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA
| | - Vaagn Andikyan
- Department of Obstetrics and Gynecology, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA.,Department of Gynecologic Oncology, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA
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21
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Analysis and Identification of Active Compounds from Gami-Soyosan Toxic to MCF-7 Human Breast Adenocarcinoma Cells. Biomolecules 2019; 9:biom9070272. [PMID: 31295870 PMCID: PMC6681368 DOI: 10.3390/biom9070272] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 07/08/2019] [Accepted: 07/08/2019] [Indexed: 12/21/2022] Open
Abstract
Gami-soyosan is a medicinal herbal formulation prescribed for the treatment of menopausal symptoms, including hot flashes and osteoporosis. Gami-soyosan is also used to treat similar symptoms experienced by patients with breast cancer. The incidence of breast cancer in women receiving hormone replacement therapy is a big burden. However, little is known about the components and their mechanism of action that exhibit these beneficial effects of Gami-soyosan. The aim of this study was to simultaneously analyze compounds of Gami-soyosan, and determine their cytotoxic effects on estrogen receptor (ER)-positive MCF-7 human breast adenocarcinoma cells. We established a simultaneous analysis method of 18 compounds contained in Gami-soyosan and found that, among the various compounds in Gami-soyosan, gallic acid (1), decursin (17), and decursinol angelate (18) suppressed the viability of MCF-7 cells. Gallic acid (1), decursin (17), and decursinol angelate (18) induced apoptotic cell death and significantly increased poly (ADP-ribose) polymerase (PARP) cleavage and the Bcl-2-associated X protein/ B-cell lymphoma 2 (Bax/Bcl-2) ratio. Decursin (17) increased the expression of cleaved caspases-8, -9, -7, and -3. Decursinol angelate (18) increased the expression of cleaved caspase-8 and -7. These three components altered the different apoptosis signal pathways. Collectively, gallic acid (1), decursin (17), and decursinol angelate (18) may be used to inhibit cell proliferation synergistically in patients with ER-positive breast cancer.
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22
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Martin TA, Israel IL, Fillion MM. An Unexpected Presentation of Male Breast Cancer in Ectopic Breast Tissue. Am Surg 2019. [DOI: 10.1177/000313481908500703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Tasha A. Martin
- New Hanover Regional Medical Center Wilmington, North Carolina
| | - Irene L. Israel
- New Hanover Regional Medical Center Wilmington, North Carolina
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23
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Invasive carcinoma in accessory axillary breast tissue: A case report. Int J Surg Case Rep 2019; 59:152-155. [PMID: 31163330 PMCID: PMC6545400 DOI: 10.1016/j.ijscr.2019.05.037] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 05/08/2019] [Accepted: 05/16/2019] [Indexed: 02/01/2023] Open
Abstract
Accessory breast cancer is a rare entity with incidence of around 0.2%–0.6%. Routine mammograms can miss accessory breast tissue due to its location. General lack of awareness of accessory breast cancer among clinicians has potentially dangerous implications. Accessory breast cancer does not require mastectomy unless involved by cancer.
Introduction Accessory or ectopic breast tissue is an aberration of normal breast development. It is known to be a rare entity present anywhere along the embryologic mammary streak or milk line but more common in axilla. Presentation of case We report a case of 36 year old female with accessory breast carcinoma who presented with a progressive lump in her left axilla for 1 year. On examination a 2 cm solitary mass was palpable in axilla. Ultrasound confirmed a 19 mm mass with no other lesion in breast and axilla. Core biopsy showed invasive ductal carcinoma. She was discussed in multidisciplinary board meeting and was offered upfront surgery with excision of accessory breast tissue and sentinel lymph node biopsy. Axillary lymph node dissection was omitted following ACOSG Z0011 criteria. She was offered adjuvant chemotherapy and radiation post operatively along with endocrine treatment as she was hormone receptor positive. Discussion Accessory breast development is hormone dependent just like normal breast. Breast cancer in accessory breast tissue is very rare. The incidence is around 6%. Most common pathology is invasive ductal carcinoma (50–75%). The most common location is axilla (60–70%) although it can present in other less common locations like infra-mammary region (5–10%) and rarely in thighs, perineum, groin, and vulva. Conclusion Since accessory axillary breast tissue is out of the image of screening breast examination, it is necessary for the oncologists to be aware of this entity and associated pathologies. Their preventive excision in high risk women can also be considered.
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24
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Fachinetti A, Chiappa C, Arlant V, Lavazza M, Liu X, Dionigi G, Pergolizzi FP, Catalfamo A, Rovera F. Metachronous bilateral ectopic breast carcinoma: a case report. Gland Surg 2018; 7:234-238. [PMID: 29770317 DOI: 10.21037/gs.2017.11.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
An incomplete regression of the mammary line during embryogenesis occurs in 0.2-6% of the population, which may result in the presence of ectopic breast tissue (EBT). The development of a carcinoma in the EBT is a rare event. The authors present a case report of a 76-year-old female patient, with a lobular carcinoma in an abdominal wall EBT submitted to surgery and adjuvant chemotherapy.
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Affiliation(s)
- Anna Fachinetti
- 1st Division of Surgery, Senology Research Center, Department of Surgical Sciences and Human Morphology, University of Insubria (Varese-Como), Varese, Italy
| | - Corrado Chiappa
- 1st Division of Surgery, Senology Research Center, Department of Surgical Sciences and Human Morphology, University of Insubria (Varese-Como), Varese, Italy
| | - Veronica Arlant
- 1st Division of Surgery, Senology Research Center, Department of Surgical Sciences and Human Morphology, University of Insubria (Varese-Como), Varese, Italy
| | - Matteo Lavazza
- 1st Division of Surgery, Senology Research Center, Department of Surgical Sciences and Human Morphology, University of Insubria (Varese-Como), Varese, Italy
| | - Xiaoli Liu
- Division of Thyroid Surgery, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Japan Union Hospital of Jilin University, Changchun 130000, China
| | - Gianlorenzo Dionigi
- Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital Policlinico "G. Martino", University of Messina, Messina, Italy
| | - Francesca Pia Pergolizzi
- Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital Policlinico "G. Martino", University of Messina, Messina, Italy
| | - Antonina Catalfamo
- Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital Policlinico "G. Martino", University of Messina, Messina, Italy
| | - Francesca Rovera
- 1st Division of Surgery, Senology Research Center, Department of Surgical Sciences and Human Morphology, University of Insubria (Varese-Como), Varese, Italy
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25
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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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26
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Teke Z, Kabay B, Akbulut M, Erdem E. Primary Infiltrating Ductal Carcinoma Arising in Aberrant Breast Tissue of the Axilla: A Rare Entity. Report of a Case. TUMORI JOURNAL 2018; 94:577-83. [DOI: 10.1177/030089160809400422] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 52-year-old woman presented with a palpable nodule in the right axilla. Physical examination revealed a 2.5 × 2.5 cm, nontender, firm, brownish, and peripherally hyperemic mass with overlying skin retraction on the right anterior axillary fold. Bilateral mammogram was negative. Ultrasonography of the right axillary region showed a 1.8 × 1.1 cm, poorly defined hypoechoic mass with irregular margins and posterior acoustic shadowing. Fine-needle aspiration biopsy of the mass revealed malignant epithelial cells. The patient underwent a wide local excision of the right axillary lesion with en bloc axillary lymph node dissection. Histopathological examination revealed an infiltrating ductal carcinoma. Here we report this case of carcinoma originating from aberrant breast tissue in the axilla. It is suggested that subcutaneous lesions of uncertain origin around the periphery of the breast should be suspected for breast carcinoma and treated appropriately.
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Affiliation(s)
- Zafer Teke
- Department of General Surgery, Pamukkale University, School of Medicine, Kinikli, Denizli, Turkey
| | - Burhan Kabay
- Department of General Surgery, Pamukkale University, School of Medicine, Kinikli, Denizli, Turkey
| | - Metin Akbulut
- Department of Pathology, Pamukkale University, School of Medicine, Kinikli, Denizli, Turkey
| | - Ergun Erdem
- Department of General Surgery, Pamukkale University, School of Medicine, Kinikli, Denizli, Turkey
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27
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Eom HJ, Ko BS, Song IH, Gong G, Kim HH. Ectopic Male Breast Cancer in the Perineum: A Case Report. J Breast Cancer 2017; 20:404-407. [PMID: 29285047 PMCID: PMC5744002 DOI: 10.4048/jbc.2017.20.4.404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 08/23/2017] [Indexed: 11/30/2022] Open
Abstract
Ectopic breast tissue and male breast cancer are both very rare diseases with only a few reports in the literature. Here, we present the first case of ectopic male breast cancer in the perineum. The patient was a 70-year-old man with a palpable mass in the perineum. A wide local excision and inguinal lymph node dissection revealed invasive breast carcinoma of no special type involving the skin and subcutis, and inguinal lymph node metastases. Immunohistochemical staining showed that the tumor cells were strongly positive for estrogen and progesterone receptors and negative for human epidermal growth factor receptor 2. Moreover, no p53 overexpression was observed. Herein, the clinical and pathologic features, as well as a review of ectopic male breast cancer are discussed.
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Affiliation(s)
- Hye-Joung Eom
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Beom Seok Ko
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - In Hye Song
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Gyungyub Gong
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hak Hee Kim
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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28
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Oh SW, Lim HS, Lee JS, Moon SM, Park MH. Invasive Micropapillary Carcinoma in Axillary Ectopic Breast and Synchronous Ductal Carcinoma In Situ in the Contralateral Breast. J Breast Cancer 2017; 20:314-318. [PMID: 28970859 PMCID: PMC5620448 DOI: 10.4048/jbc.2017.20.3.314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 04/11/2017] [Indexed: 11/30/2022] Open
Abstract
The development of ectopic breast tissue is attributable to the failure of primitive mammary tissue to regress after the development of the mammary ridge, except at pectoral breast sites, and is most often evident in the axillae. Several benign and malignant breast diseases have been reported in ectopic axillary breast tissues. The most common cancerous pathology of ectopic breast tissue is invasive ductal carcinoma. Ectopic breast cancer presenting with simultaneous primary cancer of the pectoral breast is extremely rare. Herein, we report an invasive micropapillary carcinoma of an axillary ectopic breast, combined with a synchronous ductal carcinoma in situ in the contralateral pectoral breast of a 61-year-old woman.
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Affiliation(s)
- Seung Won Oh
- Department of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Hyo Soon Lim
- Department of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Ji Shin Lee
- Department of Pathology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Sung Min Moon
- Department of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Min Ho Park
- Department of Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
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29
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Miles RC, Amornsiripanitch N, Scheel J. Inflammatory breast cancer in accessory abdominal breast tissue. Radiol Case Rep 2017; 12:639-641. [PMID: 29484038 PMCID: PMC5823292 DOI: 10.1016/j.radcr.2017.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 08/11/2017] [Accepted: 08/12/2017] [Indexed: 11/26/2022] Open
Abstract
Accessory breast tissue results from failure of the embryologic mammary ridge, also known as the milk line, to involute. As a result, ectopic breast tissue can develop anywhere along this ridge, which extends from the axilla—the most common location—to the groin. Primary breast cancer in accessory breast tissue is uncommon but has been reported in multiple prior studies. We present a rare case of inflammatory breast cancer presenting in upper abdominal accessory breast tissue in women with a personal history of ipsilateral breast cancer, and highlight the challenges of both diagnosis and treatment of breast cancer in accessory breast tissue.
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Affiliation(s)
- Randy C Miles
- Department of Radiology, University of Washington School of Medicine, 825 Eastlake Avenue East, G3-200, Seattle, WA, 98109-1023, USA
| | - Nita Amornsiripanitch
- Department of Radiology, University of Washington School of Medicine, 825 Eastlake Avenue East, G3-200, Seattle, WA, 98109-1023, USA
| | - John Scheel
- Department of Radiology, University of Washington School of Medicine, 825 Eastlake Avenue East, G3-200, Seattle, WA, 98109-1023, USA
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30
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Lim HS, Kim SJ, Baek JM, Kim JW, Shin SS, Seon HJ, Heo SH. Sonographic Findings of Accessory Breast Tissue in Axilla and Related Diseases. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:1469-1478. [PMID: 28370098 DOI: 10.7863/ultra.16.06056] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 09/23/2016] [Indexed: 06/07/2023]
Abstract
Accessory breast tissue results from failed regression of primitive mammary tissue and is most often located in the axilla. Accessory breast tissue itself is normal and should not be misdiagnosed as an abnormality. Both benign and malignant diseases that occur in the normal breast can also develop in accessory breast tissue in the axilla. In this pictorial essay, we show sonographic findings of normal accessory breast tissue in the axilla and various lesions that occur in accessory axillary breast tissue, along with other imaging findings and pathologic features.
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Affiliation(s)
- Hyo Soon Lim
- Department of Radiology, Chonnam National University Hwasun Hospital, Hwasun-eup, Korea
| | - Shin Jung Kim
- Department of Radiology, Chonnam National University Hwasun Hospital, Hwasun-eup, Korea
- Department of Radiology, Chonnam National University Hospital, Gwangju, Korea
| | - Jang Mi Baek
- Department of Radiology, Chonnam National University Hwasun Hospital, Hwasun-eup, Korea
| | - Jin Woong Kim
- Department of Radiology, Chonnam National University Hwasun Hospital, Hwasun-eup, Korea
| | - Sang Soo Shin
- Department of Radiology, Chonnam National University Hospital, Gwangju, Korea
| | - Hyun Ju Seon
- Department of Radiology, Chosun University School of Medicine, Gwangju, Korea
| | - Suk Hee Heo
- Department of Radiology, Chonnam National University Hwasun Hospital, Hwasun-eup, Korea
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31
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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] [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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32
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Abstract
Primary ectopic breast carcinoma in male is very rare. We report a case on a 52-year-old gentleman who presented initially with bilateral lesions in his axilla and after delayed diagnosis the right lesion was confirmed as an ectopic breast carcinoma. We reviewed the literature and discussed the significance of the case.
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33
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Famá F, Cicciú M, Sindoni A, Scarfó P, Pollicino A, Giacobbe G, Buccheri G, Taranto F, Palella J, Gioffré-Florio M. Prevalence of Ectopic Breast Tissue and Tumor: A 20-Year Single Center Experience. Clin Breast Cancer 2016; 16:e107-12. [DOI: 10.1016/j.clbc.2016.03.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 03/02/2016] [Accepted: 03/22/2016] [Indexed: 11/28/2022]
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34
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Bilateral Gigantomastia, Multiple Synchronous Nodular Pseudoangiomatous Stromal Hyperplasia Involving Breast and Bilateral Axillary Accessory Breast Tissue, and Perianal Mammary-Type Hamartoma of Anogenital Mammary-Like Glands. Am J Dermatopathol 2016; 38:374-83. [DOI: 10.1097/dad.0000000000000498] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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35
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Samanta DR, Bose C, Upadhyay A, Sheet S, Senapati SN. Ectopic Male Breast Cancer: A Case Report. J Clin Diagn Res 2015; 9:XD08-XD10. [PMID: 26436033 DOI: 10.7860/jcdr/2015/14874.6398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 07/06/2015] [Indexed: 11/24/2022]
Abstract
Carcinoma of male breast constitutes 1% of total breast malignancy. Carcinoma arising from ectopic breast tissue in male is an extremely rare entity and can be misdiagnosed. Ectopic breast tissue may be supernumerary or aberrant one. Despite morphologic difference, ectopic breast tissue presents characteristics analogous to orthoptic breast in terms of functional and pathologic degeneration. Most of the ectopic breast tissue occurs in thoracic or abdominal portion of milk line. If found in a location outside the milk line, it proves a diagnostic dilemma. We are reporting a case of 60-year-old male who presented with a fixed mass of size 10cm×8cm, in right chest wall infraclavicular area of 6 months duration. Histopathology of the mass revealed invasive duct carcinoma. He had no evidence of malignant or occult primary lesion in the bilateral mammary glands. Due to the paucity of the literature, incidence of ectopic male breast cancer and its management is not well understood. There is high probability of misdiagnosis of this disease. To the best of our knowledge this is the first described case of ectopic male breast cancer in the chest wall, not along the milk line, which is being reported here for documentation.
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Affiliation(s)
- Dipti Rani Samanta
- Assistant Professor, Department of Medical Oncology, Acharya Harihar Regional Cancer Centre , Cuttack, Odisha, India
| | - Chaitali Bose
- Senior Resident, Department of Radiation Oncology, Acharya Harihar Regional Cancer Centre , Cuttack, Odisha, India
| | - Ashish Upadhyay
- Postgraduate, Department of Radiation Oncology, Acharya Harihar Regional Cancer Centre , Cuttack, Odisha, India
| | - Saikat Sheet
- Postgraduate, Department of Radiation Oncology, Acharya Harihar Regional Cancer Centre , Cuttack, Odisha, India
| | - Surendra Nath Senapati
- Professor and Head, Department of Radiation Oncology, Acharya Harihar Regional Cancer Centre , Cuttack, Odisha, India
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36
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Male accessory breast cancer successfully treated with endocrine therapy: A case report. Oncol Lett 2015; 10:2495-2498. [PMID: 26622878 DOI: 10.3892/ol.2015.3602] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 05/20/2015] [Indexed: 12/25/2022] Open
Abstract
Male accessory breast cancer is an extremely rare tumor. Several risk factors have been identified, including genetic and hormonal abnormalities. Accessory breast carcinoma usually occurs under the axilla or in the inguinal region. Clinical diagnosis is frequently delayed due to the general lack of awareness among physicians and patients. In the present study, the case of a 63-year-old male patient who was diagnosed with accessory breast cancer at a local advanced stage was reported. However, the patient was successfully treated with endocrine therapy.
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Khanna S, Mishra SP, Kumar S, Khanna AK. Carcinoma in accessory axillary breast. BMJ Case Rep 2015; 2015:bcr-2015-210944. [PMID: 26260957 DOI: 10.1136/bcr-2015-210944] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We present a rare case of carcinoma developing in an accessory breast. The patient presented with a progressive lump in her right axilla for 1 year. On examination, there was a well-developed nipple areola complex in the right axilla overlying a hard, fixed 5 × 3 cm lump. On investigation, core biopsy revealed poorly differentiated carcinoma of the breast. Mammography also revealed features of a malignant lesion with skin and muscle infiltration. Neoadjuvant chemotherapy was administered followed by modified radical mastectomy after three cycles. Immunohistochemistry study showed positive status of oestrogen and progesterone receptors, and negative HER-2 neu. Three more cycles of chemotherapy along with 50 Gy radiotherapy were given in an adjuvant setting followed by hormone therapy.
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Affiliation(s)
- Seema Khanna
- Department of General Surgery, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | | | - Satendra Kumar
- Department of General Surgery, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Ajay Kumar Khanna
- Department of Surgery, Institute of Medical Sciences, Varanasi, Uttar Pradesh, India
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38
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Diagnosis and treatment of accessory breast cancer in 11 patients. Oncol Lett 2015; 10:1783-1788. [PMID: 26622750 DOI: 10.3892/ol.2015.3388] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 05/08/2015] [Indexed: 11/05/2022] Open
Abstract
The present study aimed to investigate the clinical characteristics, diagnosis and treatment of accessory breast cancer, and contribute valuable information regarding this rare tumour to the current literature, ultimately facilitating the development of improved treatment strategies. The present study reported the cases of 11 patients with accessory breast cancer. The patients with accessory breast cancer were admitted between January 2002 and June 2014, and the patient records were retrospectively analysed. All patients presented with a tumour that was localised in the axilla. Out of these patients, there were 8 patients with invasive ductal carcinoma and 3 patients with invasive lobular carcinoma. The follow-up periods for patients ranged between 4 and 54 months. Out of the 5 patients that experienced neoplasm metastases, 4 patients succumbed to the disease. In total, 6 patients remain alive with no evidence of disease. Accessory breast cancer is a progressive tumour, and long-term follow-up is required. A comprehensive treatment strategy may be an effective treatment option for patients; however, the optimal time at which to commence chemotherapy and the role of combined radiotherapy and endocrine therapy require additional investigation.
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Patel BK, Jafarian N, Abbott AM, Khazai L, Lee MC. Imaging Findings and Management of Primary Breast Cancer in Accessory Axillary Breast Tissue. Clin Breast Cancer 2015; 15:e223-9. [PMID: 25986957 DOI: 10.1016/j.clbc.2015.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 03/26/2015] [Accepted: 04/16/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Bhavika K Patel
- Department of Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Neda Jafarian
- Department of Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Andrea M Abbott
- Comprehensive Breast Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Laila Khazai
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Marie Catherine Lee
- Comprehensive Breast Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.
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40
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Pseudomamma of the inguinal region in a female patient: A case report. Int J Surg Case Rep 2015; 12:71-4. [PMID: 26011805 PMCID: PMC4486109 DOI: 10.1016/j.ijscr.2015.05.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 05/11/2015] [Accepted: 05/12/2015] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Supernumerary breasts are relative common benign congenital anomalies. General population occurrence rates vary up to 6% according to ethnicity and gender. Higher incidence is recorded in Asian individuals, especially Japanese. Embryonic breast development of the mammary ridge (milk line) is explained and supernumerary breast tissue resulting from involution failure of any portion of the embryonic mammary folds is described. PRESENTATION OF CASE We report a case of supernumerary breast (pseudomamma) in a female occupying her right inguinal region that was treated in the breast unit of our hospital. Differential diagnosis, imaging methods, operative approach, surgical treatment and histological verification are specified. DISCUSSION Classification system for supernumerary breast tissue is presented, high risk population is identified and congenital malformations linked to it are outlined. Evaluation of diagnostic workup and limitations are stated. Cancerous degeneration and justification for surgical removal of the accessory gland is discussed. CONCLUSION Differential diagnosis of lesions along the milk line should always be inclusive of developmental abnormalities such as any type of supernumerary breast, often overlooked due to small size, although carrying a malignant potential equal to normally positioned breasts. Surgical correction is a sensible approach, often encouraged by the patients. Additional evaluation is recommended due to the frequent accompanying urinary tract and cardiac anomalies.
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41
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Cripe J, Eskander R, Tewari K. Sentinel lymph node mapping of a breast cancer of the vulva: Case report and literature review. World J Clin Oncol 2015; 6:16-21. [PMID: 25866706 PMCID: PMC4390890 DOI: 10.5306/wjco.v6.i2.16] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Revised: 01/29/2015] [Accepted: 02/12/2015] [Indexed: 02/06/2023] Open
Abstract
Ectopic breast tissue is rare and typically presents as an axillary mass. Previous reports have identified ectopic breast tissue in the vulva, but malignancy is exceedingly uncommon. We present a 62 years old with locally advanced breast carcinoma arising in the vulva demonstrates the utilization of sentinel lymph node mapping to identify metastatic lymph nodes previously unable to be identified via traditional surgical exploration. Our case supports the principles of adjuvant therapy for breast cancer to be applied to ectopic breast cancer arising in the vulva. A literature review highlights common key points in similar cases to guide management.
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42
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Nardello SM, Kulkarni N, Aggon A, Boraas M, Sigurdson ER, Bleicher RJ. Invasive mucinous carcinoma arising in ectopic axillary breast tissue: a case report and literature review. AMERICAN JOURNAL OF CASE REPORTS 2015; 16:153-9. [PMID: 25770309 PMCID: PMC4370645 DOI: 10.12659/ajcr.892650] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Invasive mucinous carcinoma arising in ectopic axillary breast tissue is an uncommon diagnosis. While some published medical literature makes recommendations regarding the management of ectopic primaries, many of these recommendations are outdated. We therefore hope to provide general guidance with the management of this rare entity. CASE REPORT We report a case of a 70-year-old woman with primary invasive mucinous carcinoma of ectopic breast tissue. A literature study was performed on primary ectopic breast carcinoma. This case report with review of the literature was performed to provide rationales for a more conservative treatment based upon current data and treatment paradigms. Although the diagnosis of primary ectopic breast carcinoma is uncommon, the presence of a suspicious nodule along the mammary ridge should alert the clinician to consider the possibility of this diagnosis. A mammogram and ultrasound of the nodule were performed and the suspicious nodule was biopsied, confirming the diagnosis. Breast conservation was performed with standard nodal evaluation. CONCLUSIONS The management of primary ectopic breast carcinoma should be based upon current breast conservation techniques of orthotopic breast cancer. Current data suggest that standard treatment paradigms remain applicable to this rare clinical entity.
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Affiliation(s)
| | - Nandani Kulkarni
- Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Allison Aggon
- Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Marcia Boraas
- Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Elin R Sigurdson
- Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Richard J Bleicher
- Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
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43
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Lee J, Jung JH, Kim WW, Hwang SO, Kang JG, Baek J, Kim HJ, Park JY, Jeong JY, Lim JY, Park HY. Ductal carcinoma arising from ectopic breast tissue following microcalcification observed on screening mammography: a case report and review of the literature. J Breast Cancer 2014; 17:393-6. [PMID: 25548589 PMCID: PMC4278060 DOI: 10.4048/jbc.2014.17.4.393] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Accepted: 07/23/2014] [Indexed: 11/30/2022] Open
Abstract
Ectopic breast tissue can occur anywhere along the incompletely regressed mammary ridge. Among the various types of breast choristoma, ectopic breast tissue, which has only glandular tissue without a nipple or areola, is most commonly detected in axillary areas. However, ectopic breast cancer is often not detected until significant clinical symptoms have been revealed, or diagnosis is delayed. Furthermore, an examination of ectopic breast tissue tends to be omitted from a screening mammography. Especially, the microcalcifications of ectopic breast tissue are difficult to delineate on mammography. Herein, the authors report a case of ectopic breast carcinoma that showed clustered microcalcifications on screening mammography, and discuss the interpretation and implications of microcalcification in ectopic breast tissue.
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Affiliation(s)
- Jeeyeon Lee
- Department of Surgery, Breast Cancer Center, Kyungpook National University Medical Center, Daegu, Korea
| | - Jin Hyang Jung
- Department of Surgery, Breast Cancer Center, Kyungpook National University Medical Center, Daegu, Korea
| | - Wan Wook Kim
- Department of Surgery, Breast Cancer Center, Kyungpook National University Medical Center, Daegu, Korea
| | - Seung Ook Hwang
- Department of Surgery, Breast Cancer Center, Kyungpook National University Medical Center, Daegu, Korea
| | - Jin Gu Kang
- Department of Surgery, Breast Cancer Center, Kyungpook National University Medical Center, Daegu, Korea
| | - Jino Baek
- Department of Surgery, Breast Cancer Center, Kyungpook National University Medical Center, Daegu, Korea
| | - Hye Jung Kim
- Department of Radiology, Breast Cancer Center, Kyungpook National University Medical Center, Daegu, Korea
| | - Ji Young Park
- Department of Pathology, Breast Cancer Center, Kyungpook National University Medical Center, Daegu, Korea
| | - Ji Yun Jeong
- Department of Pathology, Breast Cancer Center, Kyungpook National University Medical Center, Daegu, Korea
| | | | - Ho Yong Park
- Department of Surgery, Breast Cancer Center, Kyungpook National University Medical Center, Daegu, Korea
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44
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Xu X, Gu J, Zhu C, Yu Z, Li N, Wang C, Wu B. Ectopic breast cancer in the anterior chest wall: a case report. J OBSTET GYNAECOL 2014; 35:652-3. [PMID: 25517483 DOI: 10.3109/01443615.2014.989824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- X Xu
- a Department of General Surgery , Jin Ling Hospital, Clinical School of Medical College of Nanjing University , Nanjing, Jiangsu , P. R. China
| | - J Gu
- a Department of General Surgery , Jin Ling Hospital, Clinical School of Medical College of Nanjing University , Nanjing, Jiangsu , P. R. China
| | - C Zhu
- b Department of General Surgery , Shanghai No.9 People's Hospital affiliated to Shanghai Jiaotong University , Shanghai , P. R. China
| | - Z Yu
- a Department of General Surgery , Jin Ling Hospital, Clinical School of Medical College of Nanjing University , Nanjing, Jiangsu , P. R. China
| | - N Li
- a Department of General Surgery , Jin Ling Hospital, Clinical School of Medical College of Nanjing University , Nanjing, Jiangsu , P. R. China
| | - C Wang
- c Department of Thoracic Surgery , Jin Ling Hospital, Clinical School of Medical College of Nanjing University , Nanjing, Jiangsu , P. R. China
| | - B Wu
- d Department of Pathology , Jin Ling Hospital, Clinical School of Medical College of Nanjing University , Nanjing, Jiangsu , P. R. China
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45
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Cáncer de mama ectópico axilar. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2014. [DOI: 10.1016/j.gine.2013.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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46
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Synchronous ipsilateral carcinoma of the accessory mammary gland and primary lymphoma of the breast with subsequent rectal carcinoma: report of a case. World J Surg Oncol 2014; 12:286. [PMID: 25217973 PMCID: PMC4247717 DOI: 10.1186/1477-7819-12-286] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 09/02/2014] [Indexed: 11/10/2022] Open
Abstract
A case of synchronous carcinoma of the accessory mammary gland and primary breast lymphoma with subsequent rectal carcinoma has not been reported previously. We present a very rare case of primary non-Hodgkin lymphoma of the left breast diagnosed simultaneously with invasive lobular carcinoma of the left axillary accessory mammary gland and rectal adenocarcinoma. An 82-year-old Japanese woman presented with two palpable masses on the left chest wall. She was given a diagnosis of suspected breast malignant tumor and axillary accessory mammary gland. She underwent excision of the axillary accessory mammary gland and left mastectomy with axillary lymph node dissection. Histopathological examination revealed diffuse large B-cell lymphoma of the breast and invasive lobular carcinoma of the axillary accessory mammary gland with lymph nodes metastasis. Three months after the surgery, primary rectal adenocarcinoma was also detected by F-18 fluorodeoxyglucose positron emission tomography. Hartmann’s operation was performed, since which time the patient has been doing well.
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47
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Husain M, Khan S, Bhat A, Hajini F. Accessory breast tissue mimicking pedunculated lipoma. BMJ Case Rep 2014; 2014:bcr-2014-204990. [PMID: 25006058 DOI: 10.1136/bcr-2014-204990] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Accessory breast tissue is an uncommon condition which occurs in 0.4-6% of women. It is mostly located in the axilla where it can cause diagnostic difficulty, especially if it is unilateral and large. Usually it is bilateral and presents as an asymptomatic mass during pregnancy or lactation. The diagnosis of ectopic breast tissue is important as it can undergo the same pathological changes that occur in a normal breast, such as mastitis, fibrocystic disease and carcinoma. We present a case of a large right-sided accessory breast in a 32-year-old woman that was clinically diagnosed as pedunculated lipoma. However, subsequent histopathological examination proved it to be an accessory breast tissue with lactational changes.
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Affiliation(s)
- Musharraf Husain
- Department of Surgery, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Sabina Khan
- Department of Pathology, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Ashraf Bhat
- Department of Surgery, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Firdoos Hajini
- Department of Surgery, Hamdard Institute of Medical Sciences and Research, New Delhi, India
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48
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The ABCs of accessory breast tissue: basic information every radiologist should know. AJR Am J Roentgenol 2014; 202:1157-62. [PMID: 24758674 DOI: 10.2214/ajr.13.10930] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Accessory breast tissue, residual breast tissue persisting from embryologic development, is found in up to 6% of the population, most commonly in the axilla along the "milk line." CONCLUSION Radiologists should be able to recognize the imaging appearance of this normal variant on multiple modalities, while at the same time understanding that the same spectrum of pathologic processes that occur in normal breast tissue can occur in accessory breast tissue as well.
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49
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Hallam S, Aggarwal A, Predolac D, Cunnick G, Ashford R. Primary ectopic breast carcinoma in a supernumerary breast arising in the anterior chest wall: a case report and review of the literature. J Surg Case Rep 2013; 2013:rjt107. [PMID: 24968437 PMCID: PMC3888000 DOI: 10.1093/jscr/rjt107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Accessory mammary tissue occurs in 0.2–6% of women, and is under the same hormonal influences as breast tissue, potentially undergoing malignant transformation. Carcinomas of accessory mammary tissue account for ∼0.3% of breast cancers, 5% of which are within a supernumerary breast. Due to its rarity and the low index of clinical suspicion, it is often diagnosed at a later stage compared with breast cancer. Reports of carcinoma developing in a supernumerary breast are rare. We describe a case of a 48-year-old woman, presenting with ectopic breast carcinoma within a supernumerary breast below the inframammary fold. We describe the mode of presentation, diagnosis and treatment with reference to the available literature. The radiotherapy treatment plan is discussed in detail to provide reference for future cases as the available literature offers no formal guidance on radiotherapy dose, fractionation or treatment field.
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50
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Okubo M, Tada K, Niwa T, Nishioka K, Tsuji E, Ogawa T, Seto Y. A case of breast cancer in the axillary tail of Spence - enhanced magnetic resonance imaging and positron emission tomography for diagnostic differentiation and preoperative treatment decision. World J Surg Oncol 2013; 11:217. [PMID: 24004816 PMCID: PMC3844328 DOI: 10.1186/1477-7819-11-217] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 08/27/2013] [Indexed: 11/24/2022] Open
Abstract
Background The management of cancer in the axillary area depends on the etiology of the tumor. Case Report A 37-year-old woman presented with a 2 cm mass in the axillary fossa. Core needle biopsy revealed adenocarcinoma. There were no abnormal breast findings on physical examination, mammography, or ultrasonography. However, enhanced magnetic resonance imaging (MRI) and positron emission tomography (PET) showed a segmentally-distributed, abnormal area in the upper-outer quadrant, continuous with the axillary mass. Samples of this area obtained by vacuum-assisted biopsy showed intraductal carcinoma. These findings indicated that the axillary lesion was a part of primary breast cancer originating from the axillary tail. Based on these results, the patient underwent total mastectomy with sentinel lymph node biopsy. Pathological examination of the specimen showed invasive ductal carcinoma accompanied by intraductal carcinoma extending up to 8.5 cm. Our case suggests that enhanced MRI and PET can provide useful preoperative information for the management of axillary breast lesions.
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Affiliation(s)
- Mai Okubo
- Department of Breast and Endocrine Surgery, The University of Tokyo Hospital, Japan 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
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