Diagnosis and treatment of accessory breast cancer in 11 patients

Abstract

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. IntroductionPrimary carcinomas of ectopic breast tissue have been reported in only a small number of cases and the axilla was the most frequent site of the primary tumor (1). Evans et al (2) reported that 71% of ectopic breast cancers were located in the axilla. Marshall et al (3) reported that 58% occurred in the axilla, 18.5% in the parasternal, 8.6% in the subclavicular, 8.6% in the submammary, and 4% in the vulvar; 94.7% of patients were women, and only 5.3% were men. Breast tissues develop from the ectodermal ridges, also known as the milk lines, on the ventral surface of the body, which extend from the axillae to the inguinal regions and end on the medial aspect of the thighs on each side of the body (4). Embryologically, ectopic breast tissue develops as a result of failed resolution of the mammary ridge, an ectodermal thickening that extends from the axilla to the groin (5). Ectopic breast tissue may appear at any site along the milk line, but it occurs most commonly in the axill; less commonly, it may appear in locations outside of the mammary ridge, including the face, middle back, buttock, posterior neck, chest, vulva, hip, posterior, flank and/or lateral thigh, shoulder and upper extremities (4,6).The diagnostic procedures and therapeutic management of accessory breast carcinoma are not definitively established. The present study aimed to perform an analysis of a series of patients with accessory breast cancer that were treated exclusively with combination chemotherapy and radiotherapy, as well as to review the medical literature with regard to the clinical features, treatment methods and prognosis of this disease. The present study reports 11 such cases, with the goal of contributing valuable information about this unusual tumour to the current literat...

Primary ectopic breast carcinoma of the axilla in a male patient

“…The most commonly reported clinical feature is the presence of a palpable mass [4]. Swelling, erythema, pain and discomfort are less often observed.…”

Cáncer en mama axilar: Revisión de la literatura a propósito de un caso.

“…El tejido mamario se desarrolla generalmente a lo largo de la cresta mamaria embrionaria, también denominada línea de la leche, derivada del ectodermo, y que se extiende bilateralmente en la superficie ventral del cuerpo, desde el pliegue axilar anterior hasta la zona media inguinal y muslo, y aparece en la sexta semana de gestación (2,3,12,13,14) . La línea de la leche involuciona durante la embriogénesis, con excepción de la cresta mamaria de la región torácica, donde el tejido se desarrolla normalmente (2,3,15) .…”

“…Sin embargo, se puede desarrollar tejido mamario accesorio (o ectópico) debido a una regresión embriológica incompleta de la cresta mamaria (3,15) . La presencia de este tejido mamario accesorio es infrecuente, con una incidencia de 0,22 a 6% de la población general (2,3,16,17) y en las mujeres sería mayor en comparación con los hombres (3) . El tejido mamario ectópico puede consistir en parénquima mamario, aréola, pezón o cualquier combinación de estos 3 componentes (2,3,18) .…”

“…El carcinoma primario del tejido mamario ectópico ubicado en la región axilar es una entidad infrecuente (1,2,3,4,5) , que generalmente se manifiesta por masa palpable (3,6) , y que por su localización atípica es de diagnóstico tardío (2,3,4,7,8,9) . Se sabe que esta neoplasia tendría un peor pronóstico comparado con el cáncer de mama normotópica, debido al pequeño tamaño del tejido, lo que favorece la rápida diseminación a la piel, pared torácica y ganglios linfáticos (1,2,4,5,10) .…”

“…Se sabe que esta neoplasia tendría un peor pronóstico comparado con el cáncer de mama normotópica, debido al pequeño tamaño del tejido, lo que favorece la rápida diseminación a la piel, pared torácica y ganglios linfáticos (1,2,4,5,10) . Debido su baja incidencia, no existen estudios randomizados sobre su manejo, el que sigue siendo crontroversial (2,3,4,7,11) , e incluye cirugía, radioterapia, quimioterapia, hormonoterapia o una combinación de ellas (2,3) .…”