INTRODUCTIONEctopic breast can be seen anywhere on the milk line from the axilla to the vulva, as a result of noncomplete normal embryological development of the breast bud. Familial transmission might be seen and breast cancer development has also been rarely reported. In this article we present a case in whom surgery was performed for an ectopic breast cancer.
CASE PRESENTATIONForty-one -year-old female patient presented complaining of a mass under her left breast, dark brownish discoloration and a tense feeling around this area for the last 7-8 months, on August 2010. Her bilateral breast and right axilla examinations were normal, a 2x2 cm hard, mobile lymph node was observed in the left axilla. The left ectopic breast was located anterior to the costal arch, its surrounding skin showed dark brownish discoloration, and a firm subcutaneous mass of 2x2 cm was palpable (Figure 1).The breasts were bilaterally normal on mammography. The breast ultrasonography (US) showed both breasts to be normal, but an ectopic breast was reported at the inferior of the left breast. Tru-cut biopsy was performed from the ectopic breast, which revealed "invasive lobular carcinoma". The patient's abdominal sonography, thoracoabdominal computed tomography and whole-body bone scintigraphy were within normal limits. This case was staged as T4N1M0 and "left ectopic mastectomy+level I-II axillary dissection" was applied (Figure 2a, b).The pathological examination of the mastectomy and axillary dissection specimen revealed residual tumor deposits in the posterior surface of the mastectomy material. Also lymphovascular invasion (+), ER 100%+, PR 100% +, c-erb B2: + and lymph node metastasis in 4/12 were determined.The patient was referred to Medical Oncology and Radiation Oncology departments. She received radiotherapy (RT), chemotherapy (CT) and endocrine therapy (ET), and is still being followed-up with no local recurrence and distant metastases.
DISCUSSIONEctopic (accessory) breast can be seen anywhere on the milk line from the axilla to the vulva, as a result of non-complete normal embryological development of the breast bud (1). It is more common than amastia. It has gained attention in history beginning from the early ages, the statue of Ephesian Diana is symbolic with her 20 ectopic breasts (2). Ectopic breast can be seen in three ways. 1-Numerous nipples 2-Numerous nipple-areola complex 3-Numerous breast.The rate of ectopic breast is 1-4% in Caucasians. This abnormality is more common in the Far East. It can be seen in both sexes. There is familial transmission. Its incidence is reported as 1.68% in Japanese men, Ectopic breast may be present at any site, from the axilla to the vulva, other than its normal location. Cysts, adenofibromas and rarely carcinomas have been reported in ectopic breasts. In this case report, we present a patient with ectopic breast cancer. The patient had a thickening and enlarging of her ectopic breast tissue, on the left arcus costarium. Tru-cut biopsy revealed "invasive lobular carcinoma". Left ectopic ...
We report a case of this rare tumor and describe the surgical approach that we adopted and the clinical outcome; we also report his condition at 24 months' follow-up. Although treatment was with radical surgery, sufficient shoulder function could be obtained in our patient. We also describe the interesting MR findings of this tumor which correlated well with the histopathologic findings.
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