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Accessory breast tissue

Dr Henry Knipe ◉ ◈ and Radswiki et al.

Accessory breast tissue is a relatively common congenital condition in which abnormal accessory breast tissue is seen in addition to the presence of normal breast tissue. This normal variant can present as a mass anywhere along the course of the embryologic mammary streak (axilla to the inguinal region).

On this page:

Article:

Common locations
Epidemiology
Clinical presentation
Pathology
Radiographic features
Treatment and prognosis
Related articles
References

Images:

Cases and figures

Common locations

chest wall
vulva
axilla
knee
lateral thigh
buttock
face
ear
neck

Epidemiology

Found in 2-6% of women and 1-3% of males ⁵. Although present from birth, patients are often not aware of it until puberty.

Clinical presentation

Most women are unaware of their accessory breast tissue and it is detected incidentally on a mammogram. Discomfort, pain, milk secretion, axillary thickening, and local skin irritation can occur. Accessory breast tissue responds to hormonal stimulation and may become more evident during menarche, pregnancy, or lactation. On examination, supranumerary nipples may also be seen.

Pathology

This tissue ranges from a small focus of parenchyma to complete structures (which may include nipple and areola).

It is also important to remember that both benign and malignant diseases of breast tissue in ectopic locations in adult women have been described.

Location

Accessory breast tissue can be found anywhere along the thoracoabdominal region of the milk line (the embryologic mammary streak) but are most frequently found in the axilla and may occur bilaterally. They are very rarely seen in the face, back, and thigh.

Associations

Various disorders associated with supernumerary nipples include:

Radiographic features

Most accessory breast tissue is found coincidentally on routine screening mammography.

Breast ultrasound

Ultrasound imaging shows breast tissue, indistinguishable from regular breast.

Breast MRI

Occasionally performed in challenging atypical cases but in practice this is rarely needed. The signal and enhancement characteristics are similar to normal glandular tissue.

Treatment and prognosis

No treatment is required in the vast majority of cases. The treatment of choice for symptomatic accessory axillary breast tissue is surgical excision as removal of the tissue will relieve physical discomfort or mechanical discomfort in the case of large volume accessory tissue.

In common with regular breast tissue, accessory mammary tissue may exhibit malignancy, fibroadenoma, mastitis, and fibrocystic change. The ectopic breast tissue has been found to have a higher propensity to develop malignancy and occurs at an earlier age. Excessive breast growth (macromastia) can be seen in pregnancy as well as during adolescence.

References

Anatomy: Thoracic

thoracic skeleton
- thoracic cage
  - ribs
    - typical ribs
    - atypical ribs
    - variant anatomy
      - bifid ribs
      - Srb anomaly
  - costal cartilage
  - sternum
- thoracic spine
- articulations
muscles of the thorax
spaces of the thorax
thoracic viscera
blood supply of the thorax
- arteries
  - thoracic aorta (development)
  - pulmonary trunk
    - left pulmonary artery
      - aberrant left pulmonary artery
    - right pulmonary artery
- veins
  - superior vena cava (cavoatrial junction)
  - inferior vena cava
  - coronary veins
    - cardiac veins which drain into the coronary sinus
      - great cardiac vein
      - middle cardiac vein
      - small cardiac vein
      - posterior vein of the left ventricle
      - vein of Marshall (oblique vein of the left atrium)
    - anterior cardiac veins
    - venae cordis minimae (smallest cardiac veins or thebesian veins)
  - pulmonary veins
    - bronchial veins
lymphatics
innervation of the thorax

Article information

rID: 11125

System: Breast

Section: Anatomy

Tag: cases, oncology, variant

Synonyms or Alternate Spellings:

Accessory breast
Accessory mammary tissue
Supernumerary breast tissue
Polymastia
Ectopic breast tissue
Mammary heterotopia

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