The tuberous breast revisited

Pacifico, Marc D.; Kang, Norbert

doi:10.1016/j.bjps.2007.01.002

Cited by 63 publications

(36 citation statements)

References 18 publications

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“…The occurrence of lactation problems among women with a prior history of such breast surgeries is well known [68,69], yet lactation literature focuses largely on the contributing factor of the surgical technique rather than any preexisting glandular pathology. Tubular or tuberous breasts, sometimes also referred to as Snoopy deformity, are well known to plastic surgeons [70]. They have previously been described as having Bnormal function but abnormal morphology^ [60], but a histological study discovered abnormalities in the arrangement and quantity of collagen fibers [71], suggesting that perhaps tuberous breasts may not be so functionally normal after all.…”

Section: Mammary Hypoplasiamentioning

confidence: 98%

Unsolved Mysteries of the Human Mammary Gland: Defining and Redefining the Critical Questions from the Lactation Consultant’s Perspective

Marasco

2014

J Mammary Gland Biol Neoplasia

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Despite advances in knowledge about human lactation, clinicians face many problems when advising mothers who are experiencing breastfeeding difficulties that do not respond to normal management strategies. Primary insufficient milk production is now being acknowledged, but incidence rates have not been well studied. Many women have known histories of infertility, polycystic ovary syndrome, obesity, hypertension, insulin resistance, thyroid dysfunction, hyperandrogenism or other hormonal imbalances, while others have no obvious risk factors. Some present with obviously abnormal breasts that are pubescent, tuberous/tubular or asymmetric in shape, raising the question of insufficient mammary gland tissue. Other women have breasts that appear within normal limits yet do not lactate normally. Endocrine disruptors may underlie some of these cases but their impact on human milk production has not been well explored. Similarly, any problem with prolactin such as a deficiency in serum prolactin or receptor number, receptor resistance, or poor bioavailability or bioactivity could underlie some cases of insufficient lactation, yet these possibilities are rarely investigated. A weak or suppressed milk ejection reflex, often assumed to be psychosomatic, could be related to thyroid dysfunction or caused by downstream post-receptor pathway problems. In the absence of sufficient data regarding these situations, desperate mothers may turn to non-evidence-based remedies, sometimes at considerable cost and unknown risk. Research targeted to these clinical dilemmas is critical in order to develop evidence-based strategies and increase breastfeeding duration and success rates.

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Section: Mammary Hypoplasiamentioning

confidence: 98%

Unsolved Mysteries of the Human Mammary Gland: Defining and Redefining the Critical Questions from the Lactation Consultant’s Perspective

Marasco

2014

J Mammary Gland Biol Neoplasia

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“…However, despite the presence of such a constricting ring has been confirmed by histological findings, the authors acknowledge that their theory is pure speculation and that it is impossible to predict whether these breasts would have undergone a normal development if this fibrous ring had not been present. In addition, a recent paper by Pacifico and Kang discarded this theory and explained the etiology of the tuberous breast in view of a transient decrease in NAC skin thickness during puberty …”

Section: Introductionmentioning

confidence: 99%

Tuberous breast and predisposition to breast deformity in consanguineous

et al. 2017

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Tuberous breast deformity is a pathologic condition of the breast consisting of a constricting ring at the breast base, reduction in the volume of the breast parenchyma, and herniation of breast tissue through the nipple-areola complex with areola enlargement. This pathology is generally congenital and has an unknown etiopathogenesis. We report the first observation of tuberous breast deformity in consanguineous. This report suggests the potential role of a genetic base in the development of this deformity. Between May 2008 and March 2011, we observed six female patients from two different families, aged between 18 and 55 years, affected by tuberous breast deformity. The breast deformity was characterized by breast asymmetry in all six cases. Four patients underwent surgery to correct the deformity. Standardized objective measurements of breast and chest were taken. A Visual Analog Scale was used to evaluate patients' and physicians' satisfaction. The first three patients were consanguineous; two were first cousins, and the third was second cousin with one of the above. The other three patients were also from the same family: two sisters and their mother. According to Von Heimburg's classification, the patients presented different degrees of breast deformity. In all operated cases, a good esthetic result with a high satisfaction (average visual analog scale score 9) was achieved. The results remained stable over time and no revisions were needed after the 1-year follow-up. The possibility of a parental consanguinity for breast deformities such tuberous breast has never been described in the literature.This report suggests the possible genetic role in the development of tuberous breast deformity. Further studies and genetic tests are required to prove this hypothesis.

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“…It is calculated by the relation between the measure of parenchymal protrusion through the areola (distance from the tip of the papilla to the base of the areola measured in centimeters) and the areolar diameter measured in centimeters. The index greater than 0.4 defines a tuberous breast, which severity could be classified in mild (0.4 to 0.5), moderate (0.51 to 0.6) or severe (0.61 To 0.7) [1,5]. The early manifestation of signs of this mammary pathology could be observed since before puberty, when hormonal factors stimulate the gland and the mammary growth, due to the anterior projection of the areola-nipple complex and the peripheral expansion of the base of the breasts [3,6].…”

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confidence: 99%

Tuberous breast in adolescent: a case report

Batista¹,

Parente²,

Bernardo³

et al. 2017

MOJS

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Submit Manuscript | http://medcraveonline.com 3. Type III -is characterized by severe constriction, with minimal breast base and apparent deficiency of all quadrants of the breast [1,4].However, this classification is very subjective, but the Northwood index is more objective, which is based exclusively on the hernia ion of the mammary parenchyma through the areola as a fundamental point in the development of the tuberous breast. It is calculated by the relation between the measure of parenchymal protrusion through the areola (distance from the tip of the papilla to the base of the areola measured in centimeters) and the areolar diameter measured in centimeters. The index greater than 0.4 defines a tuberous breast, which severity could be classified in mild (0.4 to 0.5), moderate (0.51 to 0.6) or severe (0.61 To 0.7) [1,5]. The early manifestation of signs of this mammary pathology could be observed since before puberty, when hormonal factors stimulate the gland and the mammary growth, due to the anterior projection of the areola-nipple complex and the peripheral expansion of the base of the breasts [3,6]. The breast represents an important symbol of woman's femininity and its deformity result in several psychological problems that, together with the sociocultural influences, motivate surgical interventions to improve its aesthetics [7][8][9]. In this report, it is described the rare case of a 14-year-old woman with tuberous breast and emotional changes as a result from these breast alterations. Case ReportD.C.S., a 14-year-old female patient from Juazeiro do Norte, in State of Ceará, was taken by her mother to the adolescent ambulatory at Maria Amélia Bezerra Children's Hospital. This hospital supports the Estácio de Sá College of Medicine, located in the same city. The teenager's mother reported changes in the appearance of adolescent breasts (Figure 1), which occurred two years ago, and behavioral disorders, such as aggression and introspection, attributed to this fact. Her mother also expressed intense desire to correct the alterations so that she could have a satisfactory anatomical and psychological development. Physical examination: shy expression, uncommunicative, but collaborative patient; hypotrophic mammary parenchyma bilaterally; breasts with enlarged areolas and the right breast was lower, showing asymmetry of both breasts; the right breast was larger than the left; finally, a constrictive ring was present at the base of the breasts (Figure 2). A two-time surgical correction was proposed SummaryThe tuberous breast is a rare pathology that affects mainly young women and is characterized by deformities that strike the breasts, such as an enlarged areola, less breast tissue, flaccidity and a close base in the fold of the breast. In the case report, it is a 14-year-old female patient with tuberous breasts and emotional disorders such as aggression, introspection and low self-esteem as a result of the psychological influence of breast changes. After medical exam, a surgical procedure and psychological t...

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The tuberous breast revisited

Cited by 63 publications

References 18 publications

Unsolved Mysteries of the Human Mammary Gland: Defining and Redefining the Critical Questions from the Lactation Consultant’s Perspective

Unsolved Mysteries of the Human Mammary Gland: Defining and Redefining the Critical Questions from the Lactation Consultant’s Perspective

Tuberous breast and predisposition to breast deformity in consanguineous

Tuberous breast in adolescent: a case report

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