axillary accessory breast tissue ultrasound

The accessory breast tissue most commonly (approximately 67 %) occurs in the thoracic or abdominal pathway of the milk line, more commonly just below the inframammary crease. No solid or cystic . Accessory breast tissue is defined as "residual [breast] tissue that persists from normal embryolog- ic development" [1]. Axillary breast tissue, which may be an extension of the tail of Spence, is a normal variant that has been reported in the literature relatively infrequently, although it may be present in a number of asymptomatic women. 1 These axillary masses are thought to be caused by remnant accessory breast tissue and an excessive buildup of dermafat. Download chapter PDF On examination a 2 cm solitary mass was palpable in axilla. The armpit is composed of vascular structures such as the artery and vein, nerves and lymph nodes as well as the overlying fat, occasionally accessory breast tissue, skin and subcutaneous glands. Any pathologic process that occurs in the breast can also occur in the accessory tissue. Despite fibroadenoma being a common breast lesion, it is rare to develop over the accessory breast tissue in the axilla. Ultrasound is routinely used for the assessment of the axilla to assess lumps and pain, including in the use of assessing lymph nodes for enlargement . Because this breast tissue is made up of some fatty elements, it's possible that exercise and fat loss . 1 They may present as asymptomatic masses or cause pain, restriction of arm movement, . Accessory breast tissue is defined as "residual [breast] tissue that persists from normal embryologic development" [ 1 ]. Lymphoma Lymphoproliferative diseases frequently involve the axilla. Axillary ultrasound shows metastatic lymphadenopathy ( between calipers) with cystic change, which may occur in ovarian carcinoma. The patient was a 32-year-old lactating woman presented to our hospital for considerable swelling in the left axilla. The most common sites for accessory breast tissue are just below the breast and the axilla. In my opinion, a small scar is much better than a breast where one doesn't belong! Symptoms associated with an axillary accessory breast (AAB) may newly develop or worsen after pregnancy. He came for further treatments due to progressive growth of the mass for 11 months with bloody ulceration for more than 1 month. The prevalence rate of accessory breast in the axillary is 2-6%. The combined survival beyond the 4-year post-treatment period was 9.4%. If your lumps are just healthy breast tissue, then you can decide if you want them removed. A specific, radiography-aided diagnosis of accessory axillary breast tissue can eliminate unnecessary biopsy. that the axillary swelling is accessory breast tissue which has enlarged during lactation works only when breast ABSTRACT Background:The axillary accessory breast tissue develops as part of polymastia along the milk line. If the tissue is not breast tissue and just excess fat, exercise and a healthy diet can help. Accessory breast (AB) is extra and ectopic breast tissue. Accessory breast needs to be removed, as there can be bulging locally and pain, which occurs rarely. We report a patient whose biopsy of a suspicious lesion in the axilla present for one year revealed invasive ductal carcinoma (IDC). This review article discusses Paget's disease etiology, clinical presentation, differential diagnosis, diagnostic work-up, natural history and prognosis. . No associated significant hypervascularity. On examination a 2 cm solitary mass was palpable in axilla. It can be of any Kajava type though we have seen only type 4 in axilla. The imaging appearance are indeterminate, U3 (Royal College of Radiologist, Breast Group Classification). Open in a separate window Figure 2 Ultrasound scan of right axillary accessory breast tissue shows focal area of illdefined hypoechogenicity underlying the dermis measuring 10.9 × 8.3 mm (blue arrow). Failure of involution of the milk line results in accessory breast tissue, most commonly in the axilla, but it can occur anywhere from the axilla to the inguinal region. . The presence of galactocele in the axillary accessory breast is a rare occurrence [4, 5]. These lesions include soft tissue masses associated with nontumorous conditions (accessory breast tissue and chronic granulomatous inflammation) and benign and . ssory breast cancer found in our hospital. There was presence of breast tissue and absence of lymphoid tissue in the biopsy, suggesting a breast malignancy. Also known as ectopic breast tissue, accessory breast tis- sue can be found in up to 6% of the population [2]. J Ultrasound Med. Ultrasound scan of the right axilla showed accessory breast tissue measuring 56 × 50 mm in its maximum dimension without any abnormal axillary lymph nodes. OBJECTIVE. . Fibroadenoma (FA) in AB is a rare finding. Nevertheless, axillary fibroadenoma developed from ectopic breast tissue is a rare condition. If you have axillary breast tissue, exercise is not likely to make a big difference. This line extends from the axillary region down to the groin . For brevity, this section of the article will focus on the management of benign axillary accessory breast tissue, . Volume 32, Issue 7 p. 1261-1270. . Sonographic Findings of Accessory Breast Tissue in Axilla and Related Diseases. At the ultrasound, it presented characteristics that classified it as Bi-Rads® 4. Radiographically the accessory tissue resembled the remaining normal glandular tissue but was separate from it. Ultrasound confirmed a 19 mm mass with no other lesion in breast and axilla. Epidemiology Also under discussion was 24075 (upper arm) The doctor was a ob-gyn surgeon, and supplied 19120. 2017 Jul;36 (7):1469-1478. doi: 10.7863/ultra.16.06056. Fibroadenoma measuring 2.5 cm in an axillary accessory breast (AAB) in a 38-year-old woman who underwent surgery. surgical excision, liposuction or both can be done for axillary accessory breast tissue. They should always be looked for while examining a patient for breast cancer and any changes should be noted. Core biopsy showed . It is mostly located in the axilla where it can cause diagnostic difficulty, especially if it is unilateral and large. Ectopic breast tissue is at risk for benign and malignant breast disease with reported diagnoses of fibrocystic disease, mastitis, fibroadenoma, atypical hyperplasia, and carcinoma [4-6]. 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. This normal variant can present as a mass anywhere along the course of the embryologic mammary streak (axilla to the inguinal region). Clinical and sonographic examination of both breasts revealed no abnormalities and no lymph nodes were detected in the axillae or the neck. Computed tomography (CT) scan of the chest with contrast demonstrated a 4.0 x 3.6 cm, irregular, ill-defined mass with spiculated borders associated with skin retraction and involvement of . Accessory breast tissue results from failed regression of primitive mammary tissue and is most often located in the axilla. We evaluated the optimal time for AAB excision and assessed variations in clinical presentations and surgical outcomes associated with pregnancy . Furthermore, the palpable lump showed indeterminate characteristics (U3) measuring 10.9 × 8.3 mm ( Fig. The lump in her axilla was palpable and hard. Definition of axillary does include areolar tissue. 1). The presence of galactocele in the axillary accessory breast is a rare occurrence [4, 5]. Accessory breast tissue is a relatively common congenital condition in which abnormal accessory breast tissue is seen as a mass anywhere along the course of embryologic mammary streak in addition to the presence of normal breast tissue. A prominent or sagging axillary mound, appearing as a mass in the axilla, is the most frequently encountered form of polymastia, or ectopic breast. Congenital developmental anomaly-accessory breast tissue Breast tissue develops from the mammary ridges that extend from the base of the forelimb bud along the ventral surface of the embryo to an area medial to the base of the hind limb bud, which is the primitive inguinal region. Also known as ectopic breast tissue, accessory breast tissue can be found in up to 6% of the population [ 2 ]. If axillary breast tissue becomes symptomatic, this usually occurs during pregn … 2 ). Diagnosis: Pathological examination manifested a grade II infiltrating ductal . We report a galactocele with malignant appearance on ultrasound in the accessory breast. By birth, the breast bud has developed a network of small branching ducts. The remaining 13% of the aberrant sites include face, posterior neck, chest . Accessory breast tissue itself is normal and should not be misdiagnosed as an abnormality. Biopsy any lumps. Axillary accessory breast usually presents as . Adler DD, Rebner M, Pennes DR. Accessory breast tissue in the axilla: mammographic appearance. Other causes of axillary mass such as lymphadenopathy, sebaceous cyst or lipoma should be considered as differential diagnosis [ 1 ]. Although data are limited, accessory breast cancer appears to have a poorer prognosis than cancer in pectoral breasts. Accessory axillary breast tissue is present in approximately 2% to 6% of women. The highest incidence occurs in the Japa- nese population [3], with the lowest incidence The axilla and vulva are the most common sites , but ectopic breast tissue has been reported at numerous other sites including the face, neck, shoulder, flank, hip, thigh, anus, and foot [1, 9-11]. Bookmarks. Second, the presence of an abnormal lymph node can be related to an underlying . Masses arising from other components of the axilla Accessory breast tissue. Excision and liposuction are the recommended treatments. (January 30, 2022) Abrikossoff Tumor Clinically Mimicking Carcinoma in Accessory Axillary Breast Tissue . 20.7 and . It is not connected to the pectoral breast tissue. Accessory breast tissue occurs in 2-6 % of women (Fig. (b) Non-contrast MRI in 2015: Fat-saturated T2 weighted coronal image demonstrates a fusiform shaped axillary mass . This line extends from the axillary region down to the groin . Magnetic resonance imaging revealed an oval . Claim CME AMA Credits. Ultrasound showed an oval lymph node in the level I axilla (12*6mm) with blurred and unclear fatty hilum, suspicious for malignancy. The first mammogram and breast ultrasound in February 2021 showed a huge mass with lobulated border and internal cystic clefts at the right axilla with an approximate size of 7.9 × 6.0 cm ( Fig. On mammography, lymphoma shows well-defined, markedly enlarged, and homogeneously hyperdense lymph nodes [ 20 ]. It frequently presents as a palpable axillary lump. 8. Accessory axillary breast tissues are common em- briogenic alterations found in 1% to 6% of women that often manifest bilaterally [1,2]. In case of an accessory breast tissue cancer some authors recommend J Ultrasound Med. Core biopsy showed invasive ductal carcinoma. 4-6 per cent of the general population but are more common in Asian women 3. Ultrasound of the axilla revealed a Breast Imaging-Reporting and Data System (BI-RADS) 5, ill-defined, hypoechoic mass measuring 3.5 cm in size (Figure 2). Similarly, accessory breast tissue appears the same as normal breast tissue on ultrasound. This study aims to present a case of FA in axillary AB mimicking carcinoma of unknown primary (CUP). Axillary Breast Tissue Axillary lump Common causes of an axillary lump include lymph nodes, skin lesions and accessory breast tissue. The lump in her axilla was palpable and hard. The diagnosis, histogenesis, and management of Abrikossoff tumors of the breast are discussed. . Female patient, 23 years old, with the presence of hardened palpable node in the right axilla. Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine, 03 Apr 2017, 36(7): 1469-1478 DOI: 10.7863/ultra.16.06056 PMID: 28370098 . This is of common occurrence in women. Accessory breast tissue, also known as polymastia, is a relatively common congenital condition in which abnormal accessory breast tissue is seen in addition to the presence of normal breast tissue. Fibroadenoma (FA) in AB is a rare finding. Ultrasound will characterise nodes in the majority of cases. Accessory breast tissue results from failed regression of primitive mammary tissue and is most often located in the axilla. . She had a mass in her right breast for 5 years. Ultrasound examination revealed a hypoechoic mass with heterogeneous . Axillary accessory breast usually presents as . Some cancers or other abnormalities can consequently develop in the axilla and can be missed if the axilla is not scanned . The greater use of neoadjuvant chemotherapy (NCT) and the development and application of specific therapeutic targets has led to complete pathological response in up to 45% of triple negative patients and up to 60% . Breast cancer in accessory breast tissue is very rare. 2017;36(7):1469-78. Most common pathology is invasive ductal carcinoma (50-75%). Accessory breast tissue: mass in the axilla Discussion Accessory breasts occur in 0.4-6% of women. Patient concerns: We report a male senile patient suffering from a painful, enlarged, and hardened right axillary mass for more than 20 years. When found on mammography, accessory axillary breast tissue should be recognized as a normal developmental variant rather than considered a pathologic lesion, although carcinoma can develop in the accessory tissue. A total of 90 cases of carcinoma of ectopic breast tissue were found, 64 of which occurred in the axilla. Introduction: Accessory breast (AB) is extra and ectopic breast tissue. 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. She was discussed in multidisciplinary board meeting and was offered upfront surgery with excision of accessory breast tissue and sentinel lymph node biopsy . Both benign and malignant diseases that occur in the normal breast can also develop in accessory breast tissue in the axilla. Fibroadenoma (FA) in AB is a rare finding. One third of women with breast cancer begin with locally advanced lymph node disease 1 and were classically candidates to undergo axillary lymph node dissection (LND). However, studies have shown that in the absence of breast lump and a negative ultrasound imaging, the risk of having occult breast cancer with axillary lymph node metastasis is less than 1% of all breast cancers. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Axillary Breast Tissue. Operative report procedure was: Excision Axillary Mass: Audit says to code 23075/76. . The appearance of accessory . Accessory breasts, also known as polymastia, supernumerary breasts, or mammae erraticae, is the condition of having an additional breast.Extra breasts may appear with or without nipples or areolae.It is a condition and a form of atavism which is most prevalent in male humans, and often goes untreated as it is mostly harmless. . Fibroadenoma is a common breast mass that accounts for approximately half of all breast lesions in young women. Get a mamogram, sonnogram and MRI. The axillary breast is a type of accessory breast, located in the axilla. These lesions include soft tissue masses associated with nontumorous conditions (accessory brea … Introduction Accessory breast (AB) is extra and ectopic breast tissue. An aspiration . as: Olivier L, Naraynsingh V, Hassranah D, et al. [3-5] Incidence of accessory breast among the breast cancer population is only 0.3-6%. Although this finding has been reported in a variety of clinical journals, such as Radiology and Human Pathology, it . Epub 2017 Apr 3. 4) [9, 10] and can be appreciated on mammography, ultrasound and MRI. Tip. First priority is to check for cancer. Review. . Ultrasound confirmed a 19 mm mass with no other lesion in breast and axilla. Radiologists should be able to recognize the imaging appearance of this normal variant on mammography and ultrasound. We report a rare case of a 28-year-old female patient with an accessory axillary breast GCT. Normal Variants. The combined survival beyond the 4-year post-treatment period was 9.4%. Routine bilateral breast ultrasound and mammogram was done which confirmed the presence of a 1.5 × 1.8 × 1.9 cm mass in the left axilla. Introduction: Accessory breast (AB) is extra and ectopic breast tissue. . Axillary ultrasound in 2011 shows a well defined, hypoechoic, partially cystic mass with posterior enhancement, lying adjacent to the axillary vein. Fibroadenoma (FA) in AB is a rare finding. Time-based CME (0) Breast. It is uncommon to find such palpable masses in young patients. After childbirth, AAB engorgement and hyperplasia may occur due to milk formation. Ultrasound of both axilla showed well-defined hypoechoic smooth outline masses in both axillary regions 3 . a Preoperative frontal appearance with arms adducted.b Postoperative frontal view 2 weeks postoperatively.c The 1-cm incision along the axillary skin crease.d Accessory mammary gland tissue was removed through the 1-cm incision. of accessory breast tissue must also be considered and, as the topical breast tissue, can be the target of breast diseases, either benign or malignant. At least 6% of the population has accessory breast tissue in their axilla. Sonographic findings of accessory breast tissue in axilla and related diseases. Accessory axillary breast tissues are common embriogenic alterations found in 1% to 6% of women that often manifest bilaterally [1,2]. When accessory tissue occurs, both benign and . It shows the same appearance as that of the normal glandular tissue of the breast. The highest incidence occurs in the Japanese population [ 3 ], with the lowest incidence in white individuals [ 4 ]. First, accessory axillary breast tissue is present in 0.6%-6% of the general population (7,8). Axillary ectopic breast tissue presents bilaterally in up to 30% of cases, and its discovery should alert for the potential presence of other . The incidence is around 6%. Mammographic features of normal accessory axillary breast tissue were analyzed in 13 women, 54% of whom had positive findings on physical examination. The clinical presentation can be from asymptomatic to cyclical changes. On ultrasound evaluation, accessory breast tissue is identical to normal breast tissue and should not be misdiagnosed as an abnormality (Figs. PubMed CrossRef PubMed Central . Two main reasons might support this approach. In the absence of connection, it is simply an accessory breast tissue in the axilla. Redundant axillary tissue with early stage maceratation/rash excision may be consider a cosmetic procedure . Case report A 38-year-old female presented with a mass in her right axilla. Cpt 15839 is the only code I am aware of but is considered cosmetic with breast reduction. The axilla and vulva are the most common sites , but ectopic breast tissue has been reported at numerous other sites including the face, neck, shoulder, flank, hip, thigh, anus, and foot [1, 9-11]. Galactoceles are the most common benign breast lesions during breastfeeding period that can mimic carcinomas. WHY IT MATTERS: At least 6% of the population has accessory breast tissue in their axilla. It is found anywhere along the milk lines, with axillary localization being most frequently reported [].AB is thought to be an embryonic mammary tissue remnant that can occur with or without the nipple and areola [2,3].It is associated with an incidence of 1-6% in women which is much higher . 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