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Axillary ectopic breast tissue in the adolescent.

M De la Torre1, C Lorca-García2, E de Tomás2

  • 1Division of Plastic Pediatric Surgery, Pediatric Surgery Department, Hospital General Universitario Gregorio Marañón, c/O'Donnell, 52, 28007, Madrid, Spain. manueldltm@gmail.com.

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|July 19, 2022
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Summary
This summary is machine-generated.

Axillary ectopic breast tissue (EBT) in adolescent girls is uncommon but treatable. Surgical excision via small incisions offers excellent outcomes with minimal recurrence, making it a safe and effective option for pediatric axillary masses.

Keywords:
Accessory breastAxillaBreastPolymastiaPolythelia

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Area of Science:

  • Pediatric Surgery
  • Adolescent Gynecology
  • Surgical Pathology

Background:

  • Ectopic breast tissue (EBT) is rare in adolescents, presenting diagnostic challenges.
  • Axillary EBT, particularly Kajava's Class IV or V, requires careful consideration in pediatric patients.
  • Adolescent diagnosis of EBT is infrequent, necessitating awareness among clinicians.

Purpose of the Study:

  • To evaluate the diagnosis and management of axillary ectopic breast tissue in adolescent girls.
  • To assess the efficacy and safety of surgical excision for pediatric axillary EBT.
  • To highlight the importance of including axillary accessory breasts in the differential diagnosis of pediatric axillary masses.

Main Methods:

  • Retrospective study of girls with axillary EBT (Kajava Class IV/V) operated between 2006-2020.
  • Review of imaging, clinical, surgical reports, and histopathology findings.
  • Open excision through small axillary incisions.

Main Results:

  • Eleven adolescent girls (13-16 years) with axillary EBT were included; 18.2% had bilateral involvement.
  • The most common presentation was a 2-5 cm mass (100%), with associated cyclic pain (45%) and fluctuating volume (36%).
  • Bilateral axillary ultrasonography enabled preoperative diagnosis; open excision yielded excellent clinical and aesthetic results with no recurrence after one year. A single case of postoperative hematoma occurred, resolving without drainage.

Conclusions:

  • Axillary accessory breasts should be considered in the differential diagnosis of pediatric axillary masses.
  • Bilateral ultrasonography is recommended for accurate preoperative diagnosis of axillary EBT.
  • Minimal incision excision is a safe and effective treatment for axillary EBT in adolescents, achieving favorable outcomes.