Tuberous breast and predisposition to breast deformity in consanguineous

Abstract

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.

Review of Tuberous Breast Deformity: Developments over the Last 20 Years

“…[14][15][16] The genetic implication has been investigated in a few studies, showing a correlation among homozygous twins and consanguineous. 13,17 One study recruited six patients with positive family history: the first family was formed by three first degree and second cousins, and the second family was formed by two sisters and their mother. There was a correlation in the presence of TB among those lineages, thus presuming a possible genetic role in transmission of TB.…”

“…Among these, Muti’s technique describes the transferring of glandular tissue from the upper glandular quadrants to the inferior ones. 17 , 32…”

“…Among these, Muti's technique describes the transferring of glandular tissue from the upper glandular quadrants to the inferior ones. 17,32 Other techniques were the Puckett's technique for remodeling the glandular flap, Lejour's method of breast reduction, pedicled transverse rectus abdominis myocutaneous (TRAM), and latissimus dorsi muscle flap. 40,49,50 Puckett's and Lejour techniques are preferred in cases of higher breast volumes, which can be reshaped by autologous pedunculated flaps.…”