Dr. Frank Bures: Extra breast tissue can be found in unexpected places

2010-12-05T00:15:00Z Dr. Frank Bures: Extra breast tissue can be found in unexpected placesBy DR. FRANK BURES | Healthful Hint Winona Daily News
December 05, 2010 12:15 am  • 

A few women and fewer men can develop extra or accessory breast tissue, most commonly in the armpit area. It is called polymastia (mastos, breast, and poly, many).

I have had requests to do liposuction of this fatty area that can squeeze out over a person’s brassiere. But it is a tricky area to treat because you must always assess if the excess “fat” is that.

Many women will say they feel like they have an extra “boob” (not referring to their marital partner) hanging there. I personally have not found one there yet, but it is always in the differential diagnosis list for this area.

As I was plowing through my carefully preserved piles of pearls in the form of torn out journal articles to peruse “someday” before I die, I found a report of three cases of lumps in and in front of women’s armpits. They were misdiagnosed as fatty tumors (lipomas), lymph nodes or cysts, but were actually breast tissue. Two patients had unilateral lumps, and one had matching “baby boobs” in her armpits (which was the pits). Diagnosis was done by biopsy.

These were not fully developed breasts that functioned, and only a couple had bits of nipple tissue. Of the three, two had excisional removal because the tissue responded uncomfortably to menstrual cycle hormones, swelling and becoming a bit tender. One had a family history of breast cancer.

As we, both men and women, follow our evolutionary intrauterine development, we form a nipple line or mammary ridge from above our armpits, down across the breast area, past the bellybutton, onto the inner groin area, and down the thighs to about knees.

There are many and various tales about both wayward breasts and more often accessory nipples. Ann Boleyn, wife of Henry the Eighth, was rumored to have had an extra breast on her sternum. This was then used to claim that she was a witch, which justified her beheading.

Extra nipples are actually more frequent than breasts, especially in men. Extra nipples are called polythelia (Greek thele, nipple). On the abdomen they are frequently mistaken for odd moles.

Accessory axillary (armpit) breast tissue accounts for 60 to 70 percent of all wandering boobs. Other locales reported have included by the breastbone, beneath shoulder blade and around pubic areas. I have also in my piles a report of a reclusive man in his 70s man who showed up at an emergency room for an unrelated complaint. He was found to have an amazingly well developed breast on his posterior thigh. The picture of it was striking. The frequency of such tissue is reported to range from 2 to 6 percent in women, and half as common in men.

Breast tissue can develop breast disease, such as fibrocystic changes, mastitis and atypical ducts. Nipples alone do not. Cancer is rare, maybe 0.3 percent of all breast cancers. Mammograms or removal must be determined on an individual basis.

So, for your friendly neighborhood liposuction surgeon, the patient’s reference to her overhang as an extra boob has to be considered seriously before deciding to remove it. Like that old Bohemian liposuction saying says, “look before you lipo.”

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