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| Year : 1984 | Volume
: 30
| Issue : 1 | Page : 53-4 |
Polymastia of axilla (a case report).
Hardikar JV, Nadkarni SV
How to cite this article:
Hardikar J V, Nadkarni S V. Polymastia of axilla (a case report). J Postgrad Med 1984;30:53 |
Polymastia means the accessory breast glandular tissue with or without nipple and areola. Accessory nipple with or without rudimentary glandular tissue is called polythelia.
Polymastia is a rare condition; when it is associated without nipple, the swelling is likely to be diagnosed as lipoma, unless the histopathology is studied. This particular case is presented to highlight the importance of histopathology in suspected cases of polymastia without nipple.
Mrs., J., a 30 year old, fifth gravida, Muslim female noticed painful swellings, in both axillae at the age of sixteen during her first pregnancy. During every subsequent pregnancy and lactation, the swellings became painful and larger. There was no history of change in size of the swelling during the premenstrual period. Examination [Fig. 1] revealed bilateral, symmetrical, bilobed swellings in the axillae. The swellings were soft, tender and freely mobile, and placed in the subcutaneous plane. There were no other swellings or accessory nipples along the milk line. Clinically, a diagnosis of polymastia without nipple was considered. It was decided to excise these swellings for relief of pain during pregnancy and lactation. Secondly, it also caused much embarassment to the patient.
The patient's basic investigations were normal. She was operated under general anaesthesia. The swellings were excised through bilateral, transversely placed incisions in the axillae. The swellings did not show any evidence of a capsule and the appearance of the swelling was different from that of subcutaneous fatty tissue. Haemostasis was achieved by coagulation of small vessels. Wounds were sutured in two layers with suction drains. The excised specimens were studied for their histopathology. The suction drains were removed after 48 hours. The wounds healed with primary intention. Histology [Fig. 2] confirmed the diagnosis of accessory breast.
Accessory breasts are classified into different types depending on the presence or absence of areola and/or nipple. Incidence of accessory breast reported in the West is 1-2% in the general population.[1] In Japanese women, it is estimated to be 5%. Accessory breasts are uncommon below the pectoral region. Our multipara patient presenting with painful swellings in the axillae, noticed them during the first pregnancy; these swellings increased in size and became painful and tender during subsequent four pregnancies; this pointed strongly in favour of polymastia. The diagnosis was not considered during antenatal examinations probably because of absence of the nipple and the areola. However, the patient never gave any history of development of swelling during puberty. Subsequently, these swellings increased in size during pregnancy and lactation through hormonal influence.
Polymastia without nipple and areola occurs due to regression of ectodermal element in the skin but a normal proliferation in mesenchyme anywhere along the milk line.[2]
We are thankful to the Dean, L.T.M. Medical College and L.T.M.G. Hospital, for permitting us to publish this report.
| 1. | Gray, S. W. and Skandalakis, J. E.: "Embryology for Surgeons: Embryological Basis for the Treatment of Congenital Defects." W. B. Saunders Company, Philadelphia, London and Toronto, 1972.  |
| 2. | Langman, J.: "Medical Embryology." Third Edition, The Williams and Wilkins Company, Baltimore, 1975. |
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