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Tsuji W. Metachronous bilateral ectopic breast carcinoma in the axilla: A case report and literature review. Breast Dis 2021; 39:149-153. [PMID: 33074216 DOI: 10.3233/bd-200452] [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: 11/15/2022]
Abstract
Bilateral ectopic axillary breast carcinoma is extremely rare. Here, we report the case of a 68-year-old woman who presented with a palpable mass in the right axilla. After ectopic breast carcinoma diagnosis, the patient underwent partial mastectomy and sentinel lymph node biopsy, followed by radiotherapy of the whole breast. Adjuvant endocrine therapy was administered for 5 years. Seven years after the first carcinoma diagnosis, the patient noticed a second tumor in the left axilla by herself at the age of 75 years. Core needle biopsy revealed second primary breast carcinoma of the axilla. She underwent partial mastectomy and sentinel lymph node biopsy followed by chemotherapy, radiotherapy, and endocrine therapy. No recurrence has been observed so far. Therefore, ectopic breast carcinoma should be treated as typical breast carcinoma.
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Affiliation(s)
- Wakako Tsuji
- Department of Breast Surgery, Shiga General Hospital, Moriyama, Shiga, Japan
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Pang L, Cui M, Dai W, Wu S, Kong J. Diagnosis and Treatment of Male Accessory Breast Cancer: A Comprehensive Systematic Review. Front Oncol 2021; 11:640000. [PMID: 33854973 PMCID: PMC8039378 DOI: 10.3389/fonc.2021.640000] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background Accessory breast cancer is extremely rare, especially in male patients, and only a few cases have been reported in the literature. To date, no specific guidelines regarding its diagnosis and treatment are available. Objectives This study aimed to investigate the guidelines for the diagnosis and treatment of male accessory breast cancer by reviewing the available literature on this disease. Methods The Web of Science, Cochrane, PubMed, and CNKI databases were systematically searched (last search: 30 November 2020) to identify studies on male axillary accessory breast cancer. The following data were extracted: author names, number of patients, country, patient age, tumor location, tumor size, pathologic diagnosis, and treatment. Results There were 16 studies included (6 in Chinese and 10 in English), corresponding to 16 cases of male axillary accessory breast cancer. Primary surgical resection is currently the main procedure, followed by comprehensive treatment including chemotherapy, radiotherapy, and endocrine therapy. Patient age ranged from 51–87 years, and the average age was 67.1 years. The main clinical features of the patients were pain, the portion of the skin covering the mass was either reddish or purplish, and the mass could show swelling and erosion on the surface, with purulent exudate. Conclusions Once male accessory breast cancer is diagnosed, we can follow the latest guidelines for the diagnosis and treatment of breast cancer. Tumor biopsy and resection seems the treatment of first choice, combined with comprehensive treatment including chemotherapy, radiotherapy, and endocrine therapy.
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Affiliation(s)
- Liwei Pang
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Meiying Cui
- Department of Anesthesiology, Shengjing Hospital, China Medical University, Shenyang, China
| | - Wanlin Dai
- Innovation Institute of China Medical University, Shenyang, China
| | - Shuodong Wu
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jing Kong
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China
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Abstract
RATIONALE Accessory breast cancer is extremely rare among all cancerous diseases, especially in male patients. There were only few male axillary accessory breast cancer cases that have been reported in scientific literatures so far. Hereby, we would like to discuss a case of male axillary accessory breast cancer found in our hospital. PATIENT CONCERNS We report a male senile patient suffering from a painful, enlarged, and hardened right axillary mass for more than 20 years. He came for further treatments due to progressive growth of the mass for 11 months with bloody ulceration for more than 1 month. DIAGNOSIS Pathological examination manifested a grade II infiltrating ductal carcinoma derived from the accessory mammary gland (right axilla), with invasion of local skin. Immunohistochemical examination result: estrogen receptor (++) 90%, progesterone receptor (+++) 100%, human epidermal growth factor receptor-2 (1+), ki67 (20% positive), prostate specific antigen (-), caudal-related homeobox-2 (-), thyroid transcription factor-1 (-), Synaptophysin (+), NapsinA (1), and CK7 (-). INTERVENTIONS Modified radical mastectomy and axillary lymph nodes clearance were performed on the accessary breast cancer under general anesthesia. Postoperatively, endocrine therapy was provided for the patient, orally-taken Letrozole was recommended for the rest of the patient's life. OUTCOMES The patient recovered uneventfully and was discharged 3 days after the operation. The patient continued to take Letrozole orally regularly at home and no signs of recurrence were observed. CONCLUSION Axillary accessory breast cancer in males is extremely rare, with no conspicuous and typical clinical presentations, which leads to inevitable neglect by clinicians. Therefore, there is significant necessity for clinicians to be cautious with this type of disease.
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MESH Headings
- Aged, 80 and over
- Alzheimer Disease
- Axilla
- Breast Neoplasms, Male/diagnosis
- Breast Neoplasms, Male/diagnostic imaging
- Breast Neoplasms, Male/pathology
- Breast Neoplasms, Male/surgery
- Carcinoma, Ductal, Breast/diagnosis
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Ductal, Breast/surgery
- Diagnosis, Differential
- Humans
- Lymphatic Metastasis/diagnosis
- Lymphatic Metastasis/diagnostic imaging
- Magnetic Resonance Imaging
- Male
- Mastectomy, Modified Radical
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Affiliation(s)
- Minglei Bi
- Department of Plastic Surgery, The Affiliated Hospital of Qingdao University
| | - Danyi Li
- Department of Plastic Surgery, The Affiliated Hospital of Qingdao University
| | - Yipeng Su
- Department of Plastic Surgery, The Affiliated Hospital of Qingdao University
| | - Pengfei Sun
- Department of Plastic Surgery, The Affiliated Hospital of Qingdao University
| | - Yan Gao
- General Surgery, Qingdao West Coast New Area Central Hospital, Qingdao, China
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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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5
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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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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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Definitive treatment of supernumerary lower chest wall primary breast cancer. Pract Radiat Oncol 2012; 2:e53-e57. [PMID: 24674185 DOI: 10.1016/j.prro.2012.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Revised: 01/22/2012] [Accepted: 01/25/2012] [Indexed: 11/23/2022]
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Guèye M, Guèye SMK, Rault S, Ronzino V, Gharbi M, Renard C, Croce S, Mathelin C. [Breast cancer on a scar of excision of ectopic breast tissue: a case report]. ACTA ACUST UNITED AC 2011; 39:e55-7. [PMID: 21354849 DOI: 10.1016/j.gyobfe.2010.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2010] [Accepted: 11/03/2010] [Indexed: 10/18/2022]
Abstract
The cancerization of supernumerary breast is uncommon. So when this situation occurs, the diagnosis is often late. Cancers of ectopic breast tissue have been reported in the international literature, but to our knowledge, no cancer after excision of accessory breast gland has been published. This article describes a case of ectopic breast tissue cancer in axillary situation occurring several years after excision and details its specific diagnostic, therapeutic and prognosis.
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Affiliation(s)
- M Guèye
- Unité de sénologie, pôle de gynécologie-obstétrique, CHRU de Strasbourg, avenue Molière, Strasbourg cedex, France
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Park JS, Lee AY, Bae SG, Lee SM. Hypermetabolic Axillary Mass on (18)F FDG PET/CT: Breast Cancer Arising from Accessory Breast Tissue. Nucl Med Mol Imaging 2010; 44:300-3. [PMID: 24899969 DOI: 10.1007/s13139-010-0053-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Accepted: 09/14/2010] [Indexed: 11/30/2022] Open
Abstract
Differential diagnosis among several causes of axillary malignant mass is important. The most common cause of palpable malignant axillary mass is metastatic lymphadenopathy. Although carcinoma arising from ectopic breast tissue is rare, the diagnosis should be kept in mind when evaluating malignant axillary mass. In this report we present a case with carcinoma arising from ectopic breast tissue. (18)F FDG PET/CT was performed for the purpose of localizing primary breast cancer lesion and systemic evaluation. PET/CT showed hypermetabolic lesions only in the right axilla. There is no evidence of malignancy in both breasts. When nuclear physicians encounter a hypermetabolic axillary mass indicating malignant lesion without evidence of primary breast malignant lesion, carcinoma arising from ectopic breast tissue should be included in the differential diagnosis.
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Affiliation(s)
- Ji Sun Park
- Department of Nuclear Medicine, Inje University, Pusan Paik Hospital, 633-165 Gaegum-Dong, Pusanjin-Gu, Pusan, Korea
| | - Ah Young Lee
- Department of Nuclear Medicine, Inje University, Pusan Paik Hospital, 633-165 Gaegum-Dong, Pusanjin-Gu, Pusan, Korea
| | - Sang Gyun Bae
- Department of Nuclear Medicine, Inje University, Pusan Paik Hospital, 633-165 Gaegum-Dong, Pusanjin-Gu, Pusan, Korea
| | - Seok Mo Lee
- Department of Nuclear Medicine, Inje University, Pusan Paik Hospital, 633-165 Gaegum-Dong, Pusanjin-Gu, Pusan, Korea
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Abstract
Breast neoplasm may develop in ectopically located glandular tissue. This paper presents an interesting and rare case of a 50-year-old female who despite regular mammography screening examination developed an invasive accessory breast cancer. Clinical examination revealed a 2 cm - tumour localized 4 cm below the left inframammary fold. The lesion was immobile, the skin and the atrophic nipple were retracted, the tumour infiltrated the thoracic wall. Oligobiopsy and additional examinations showed an invasive stage IIIB ductal breast cancer (Bloom II, G-2). The receptor status was: ER(+), PGR(+), HER2(-). The increased level of cancer antigen 15.3 was found. The patient was submitted to pre-operative chemotherapy. She also underwent surgery and subsequently post-operative chemotherapy and radiotherapy. On the basis of the presented case, it could be concluded that the accessory mammary glands are out of the image of screening breast examinations. Accessory breast cancer is usually diagnosed by clinical examination and ultrasonography. Preventive resection of accessory breast in women at high risk of developing breast cancer can be considered as the treatment of choice in most patients.
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11
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Nihon-Yanagi Y, Ueda T, Kameda N, Okazumi S. A case of ectopic breast cancer with a literature review. Surg Oncol 2009; 20:35-42. [PMID: 19853438 DOI: 10.1016/j.suronc.2009.09.005] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2009] [Revised: 09/03/2009] [Accepted: 09/24/2009] [Indexed: 12/16/2022]
Abstract
A 63-year-old woman was referred to our hospital because of a right axillary nodule in 2004. Physical examination showed a spherical nodule measuring 0.5cm in diameter in the right axilla. No mass was palpable in either breast. Mammograms were normal. Ultrasonography revealed a subcutaneous hypoechoic mass 0.7mm in maximum diameter in the right axilla. The patient underwent an excisional biopsy. Histological examination revealed an invasive ductal carcinoma (scirrhous carcinoma) in ectopic breast tissue. The patient subsequently underwent a wide local excision of the tissue surrounding the biopsy scar, with axillary lymph node dissection. Histologically, no residual tumor or nodal metastasis was found. Postoperatively, she received endocrine therapy and remains well, without any evidence of recurrence 4 years 10 months after operation. Cancer of the ectopic breast tissue is rare, and most cases present as a solitary axillary mass. Long-term outcomes remain unclear. We present a case of breast carcinoma in the axillary ectopic mammary gland and summarize the clinical features of 94 cases, including ours, in Japan. We also compare long-term survival between ectopic breast cancer and usual breast cancer according to TNM T stage and lymph node metastasis.
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Affiliation(s)
- Yasuhiro Nihon-Yanagi
- Department of Surgery, Toho University Sakura Medical Center, Shimoshizu, Sakura, Chiba 285-8741, Japan.
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van Herwaarden-Lindeboom MYA, van Hillegersberg R, van Diest PJ. Ectopic lobular breast cancer on the anterior chest wall: a rare entity. J Clin Pathol 2007; 60:940-1. [PMID: 17660339 PMCID: PMC1994503 DOI: 10.1136/jcp.2005.034488] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
The presence of accessory breast tissue such as extra nipples (polythelia) and extra breast (polymastia) is relatively common, with a high incidence of being misdiagnosed in clinical medicine. Although polythelia is congenital in origin and is identifiable at childhood, polymastia may not be evident until the influence of sex hormones during puberty. In this article, we present a review of the literature concerning the historical background of accessory breasts, their incidence, their misdiagnoses, and their association with other syndromes and diseases. Finally, we present the common treatment options available today for such conditions.
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Affiliation(s)
- Marios Loukas
- Department of Anatomical Sciences, St. George's University, School of Medicine, Grenada, West Indies; the
- Department of Education and Development, Harvard Medical School, Boston, Massachusetts; and the
| | - Pamela Clarke
- Department of Anatomical Sciences, St. George's University, School of Medicine, Grenada, West Indies; the
| | - R. Shane Tubbs
- Department of Cell Biology and Section of Pediatric Neurosurgery, University of Alabama, Birmingham, Alabama
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