Triple-negative accessory breast cancer occurring concurrently with primary invasive breast carcinoma: a case report.

Introduction: Accessory breast cancer (ABC) is an extremely rare condition, particularly the presence of triple-negative ABC with ipsilateral invasive in situ breast cancer. Binary breast tumors are controversial in terms of surgical methods and comprehensive treatment. Case presentation: We share the case of a 64-year-old postmenopausal woman who presented with an underarm mass for 3 months. Ultrasonography and computed tomography suggested possible breast cancer with axillary lymph node metastasis. The patient underwent a left modified radical mastectomy combined with axillary lymph node dissection. The postoperative pathology confirmed a binary tumor, prompting us to initiate comprehensive treatment. Conclusion: We present the treatment approach for a rare case of triple-negative para-breast cancer complicated with carcinoma in situ of the breast, hoping to contribute new therapeutic ideas for the treatment of this disease.

Male Accessory Breast Cancer Successfully Treated With Single-Agent Trastuzumab: A Case Report.

Male accessory breast cancer is an extremely rare tumor. There is no report about its monotherapy and subsequent outcome prior to 2022. The current study presents the case of a 76-year-old male patient with a hard mass in the left axilla. Histopathologic examination of an excisional specimen indicated an adenocarcinoma compatible with breast carcinoma. Immunohistochemical analysis demonstrated that the mass was estrogen receptor (ER) (-), progesterone receptor (PR)(-), and human epidermal growth factor receptor type 2 (HER2) (-). A diagnosis of breast cancer originating from the accessory mammary gland in the axilla was made. Two years following surgery, the patient presented with a pulmonary lesion. Core needle biopsy was performed, and the lesion was found to be ER (-), PR(-), and HER2 (3+). The patient was successfully treated with single-agent trastuzumab. Single-agent trastuzumab could be a reasonable regimen for metastatic accessory breast cancer patients with HER2 overexpression for whom chemotherapy and endocrine therapy are not suitable.

Male triple negative axillary accessory breast cancer-a case report.

Background: Breast cancer is the most common malignancy among women worldwide. In men, cases of breast cancer are few and account for less than 1% of all cases of breast cancer. Majority of male breast cancer is hormone receptor-positive. The incidence of male breast cancer derived from axillary accessory breast is very low. Here we report a case of male triple negative axillary accessory breast cancer. Case Description: We present a case of male triple negative axillary accessory breast cancer in a 67-year-old man, which progressively increased in size through a period of 1 year. Ultrasound examination showed a 31 mm × 17 mm mass in the right axillary tail region with some accessory breast tissue around. We performed right accessory breast resection and right axillary lymph nodes dissection. Postoperative pathological analysis revealed right accessory breast invasive ductal carcinoma with apocrine metaplasia. The tumor size was 3.5 cm × 3.3 cm. In addition, 5 metastatic lymph nodes were seen in 27 axillary lymph nodes. Immunohistochemistry showed estrogen-receptor (ER) (-), progesterone-receptor (PR) (-), human epidermal growth factor receptor 2 (HER2) (2+). Fluorescence in situ hybridization (FISH) test obtained a negative result. The patient was treated with adjuvant chemotherapy and radiotherapy. Until now, no obvious signs of recurrence or metastasis have been observed during regular follow-ups. Conclusions: Male triple negative axillary accessory breast cancer is rare. Treatment of male triple negative axillary accessory breast cancer is similar to that of women. Most patients undergo surgery and adjuvant chemotherapy.

Accessory breast cancer in the inframammary region: a case report and review of the literature.

BACKGROUND: Although a few cases of accessory breast cancer (ABC) have been reported, most were in the axillary region. We encountered an extremely rare case of ABC in the inframammary region (IMR). CASE PRESENTATION: The patient was a 68-year-old postmenopausal woman who had noticed a congenital accessory nipple in her left IMR with slight, occasional discharge 20 years ago. Recently, she noticed a mass under the accessory nipple and visited a nearby clinic; fine-needle aspiration cytology of the mass revealed that it was malignant. She presented to our department 2 weeks after she had noticed the mass. Physical and imaging examinations showed an irregular tumor mass 1.7 × 1.4 × 1.0 cm in size connected to the accessory nipple beneath the left normal breast. Neither distant metastasis nor lymph node swelling was observed. Ultrasound-guided core needle biopsy revealed the mass to be invasive ductal carcinoma. We diagnosed her tumor as ABC in the left IMR; cT1cN0M0: stage IA. Curative wide resection with sentinel node biopsy was performed. Intraoperative evaluation of the frozen section revealed a hot and green ipsilateral axillary lymph node that was free from carcinoma; therefore, nodal dissection was avoided. Histopathological examination including immunochemical staining revealed that the tumor was invasive ductal carcinoma arising from the accessory breast tissue, scirrhous type, 1.7 × 1.4 × 1.0 cm in size, with a solid intraductal component. There was no lymphovascular infiltration, and the surgical margin was 1.5 cm or more. The tumor was estrogen and progesterone receptor-positive, Her2/neu-negative, and had a Ki-67 labeling index of 20%. There was no involvement of the three hot and/or green nodes. The final classification was pT1cN0(sn)M0: stage IA. Letrozole 2.5 mg/day will be administered for 5 years as adjuvant hormonal therapy. CONCLUSIONS: A cutaneous and/or subcutaneous lesion except for proper breast tissue on the milk line, or mammary ridge from axilla to groin may be an accessory breast tissue. Its serial abnormalities must be worried malignant potential to ductal carcinoma which needs some imaging and pathological examinations for definitive diagnosis and appropriate treatment according to the usual orthotopic breast cancer without delay.

Diagnosis and Treatment of Male Accessory Breast Cancer: A Comprehensive Systematic Review.

BACKGROUND: Accessory breast cancer is extremely rare, especially in male patients, and only a few cases have been reported in the literature. To date, no specific guidelines regarding its diagnosis and treatment are available. OBJECTIVES: This study aimed to investigate the guidelines for the diagnosis and treatment of male accessory breast cancer by reviewing the available literature on this disease. METHODS: The Web of Science, Cochrane, PubMed, and CNKI databases were systematically searched (last search: 30 November 2020) to identify studies on male axillary accessory breast cancer. The following data were extracted: author names, number of patients, country, patient age, tumor location, tumor size, pathologic diagnosis, and treatment. RESULTS: There were 16 studies included (6 in Chinese and 10 in English), corresponding to 16 cases of male axillary accessory breast cancer. Primary surgical resection is currently the main procedure, followed by comprehensive treatment including chemotherapy, radiotherapy, and endocrine therapy. Patient age ranged from 51-87 years, and the average age was 67.1 years. The main clinical features of the patients were pain, the portion of the skin covering the mass was either reddish or purplish, and the mass could show swelling and erosion on the surface, with purulent exudate. CONCLUSIONS: Once male accessory breast cancer is diagnosed, we can follow the latest guidelines for the diagnosis and treatment of breast cancer. Tumor biopsy and resection seems the treatment of first choice, combined with comprehensive treatment including chemotherapy, radiotherapy, and endocrine therapy.

A male with primary accessory breast carcinoma in an axilla is strongly suspected of having hereditary breast cancer.

We herein report on a male with primary accessory breast cancer in an axilla. A 75-year-old man first noticed a subcutaneous nodule about 2 cm in diameter in the area of his right axilla. The patient underwent extirpation of the mass in a public hospital. Histological examination revealed invasive breast carcinoma of no special type associated with mucinous carcinoma, invasive micropapillary carcinoma and intraductal components. Immunohistochemical analysis showed that the tumor cells were positive for Gross cystic disease fluid protein (GCDFP)-15, mammaglobin and GATA3. Staining for estrogen receptor (ER) and progesterone receptor (PR) was positive, and human epidermal growth factor receptor 2 (HER2) was negative. The Ki67 labeling index (LI) was 33.6%. Imaging revealed no evidence of a primary tumor in any other organ or in the bilateral mammary gland. We performed radical resection of the right axilla, including the scar, and axillary lymph node dissection. The final pathological examination of the surgical specimen showed normal mammary gland tissue that was not connected to the proper mammary gland, and no residual cancer or metastatic lymph nodes. Based on our clinical and pathological findings, this tumor was diagnosed as breast cancer originating from the accessory mammary gland in the right axilla. After surgery, tamoxifen was administered as adjuvant therapy. Since the surgery, 2 years ago, there has been no evidence of recurrence. Hereditary Breast and Ovarian Cancer syndrome was suspected in this case because the patient was a male with breast cancer, and he had two first-degree relatives with breast cancer. This patient had no BRCA mutations on genetic testing. Nonetheless, in cases of male breast cancer, it is necessary to obtain genetic information due to the possibility of hereditary breast cancer, including cancers associated with BRCA gene mutation.

Axillary accessory breast cancer with persistent leftsuperior vena cava: A case report and treatment controversy.

INTRODUCTION: Axillary accessory breast cancer and persistent left superior vena cava (PLSVC) are rare clinically. Many controversial treatments for accessory breast cancer are worth discussing and learning. PRESENTATION OF THE CASE: A 48-year-old woman presented with biopsy histopathology confirmed. Right axillary mass biopsy pathology showed mucinous adenocarcinoma of accessory breast. She concerned that the axillary accessory breast cancer was more likely to metastasize and unsure about whether to remove the breast. She accepted extended right axillary accessory breast resection plus ipsilateral axillary lymph node dissection (ALND) and received chemotherapy. She was found to have a PLSVC before chemotherapy. DISCUSSION: Is there a need to remove the breast and perform ALND during axillary accessory breast cancer surgery? Is sentinel lymph node biopsy (SLNB) appropriate for axillary accessory breast cancer surgery? Can negative SLNB for axillary accessory breast cancer avoid ALND? Does accessory breast cancer without axillary lymph node metastasis require local radiotherapy? Does PLSVC impact the use of peripherally inserted central catheters (PICC) tubes during chemotherapy? Patients with accessory breast cancer without breast invasion should undergo local extended resection and ALND. SLNB for accessory breast cancer cannot instead of ALND. We recommend routine axillary radiotherapy after accessory breast cancer surgery. If it is determined that the tip of PICC is not in the coronary sinus of PLSVC, PLSVC does not affect chemotherapy. CONCLUSION: Many treatment strategies for accessory breast cancer require more evidence from evidence-based medicine. It is imperative to conduct multi-center accessory breast cancer research.

Male accessory breast cancer on the abdominal wall: a case report and literature review.

BACKGROUND: Accessory breast cancer is very rare, particularly in men. Male accessory breast cancer on the abdominal wall has not been documented in the scientific literature so far. We describe a case of male accessory breast cancer on the abdominal wall. CASE PRESENTATION: We describe a male patient suffering a swelling and erosive, enlarged, and hardened abdominal wall mass with pain due to abdominal wall accessory breast cancer. The patient had no obvious disease history, and the initial clinical symptom was a small mass on the abdominal wall. B-ultrasound revealed a solid subcutaneous nodule in the right abdomen with a size of ~2.8 × 2.5 × 1.5 cm. The abdominal wall tumor resection was performed with local anesthesia. Pathological testing revealed a grade II infiltrating ductal carcinoma derived from the accessory mammary gland (right abdominal wall) with neuroendocrine characteristics, showing ER (100% strong positive), PR (100% strong positive), HER-2 (-), ki67 (40% positive), Syn (+), CgA (+), and GCDFP15 (+). CONCLUSION: Nonaxillary accessory breast cancer in males is very rare, with no obvious clinical manifestations, and could be easily ignored. This disease requires great attention from clinicians.

Accessory breast cancer: A case report and literature review / 吉林大学学报(医学版)

Objective: To analyze the clinical pathological features of one patient with accessory breast cancer (ABC), and to explore the diagnosis, treatment, operation methods and prognosis of ABC patient. Methods: The patient received right axillary tumor resection, right axillary accessory breast resection and axillary lymph node dissection, didn't receive resection of breast in the affected side. According to the intraoperative frozen pathological diagnosis, the clinical diagnosis was ABC. After operation, the patient was treated with 8 cycles of AC-T regimen adjuvant chemotherapy (The first four cycles were given pirarubicin 60 mg · m-2, cyclophosphamide 600 mg · m-2 per cycle; the last four cycles were given docetaxel 100 mg · m-2 per cycle; every three weeks was a cycle of treatment), radiation therapy (The radiation dose was 50 Gy/25 f in the upper and lower part of the right collarbone and the tumor bed area, and after retract the tumor bed area was increased to 60 Gy) and endocrine therapy (Tamoxifen was administered at 20 mg per day). Results: The patient's breast color ultrasound and mammogram examination indicated that the right axillary mass of the patient was more likely to be malignant. The clinical diagnosis was right axillary ABC. According to the NCCN guide, the patient was treated with the standardized comprehensive treatment based on surgical treatment. 16 months after operation, the patient recovered well and had a normal life. There was no upper limb dysfunction and no lateral upper limb lymphedema, and there were no recurrence or metastasis Conclusion: ABC is extremely rarely seen in clinical practice. The clinical pathological features and treatment of ABC are similar to breast cancer. If there is no lesion in the mammary gland, it is not necessary to remove the mammary gland in the affected side.

Accessory breast cancer:A case report and literature review / 吉林大学学报(医学版)

Objective:To analyze the clinical pathological features of one patient with accessory breast cancer (ABC),and to explore the diagnosis,treatment,operation methods and prognosis of ABC patient.Methods:The patient received right axillary tumor resection,right axillary accessory breast resection and axillary lymph node dissection,didn't receive resection of breast in the affected side.According to the intraoperative frozen pathological diagnosis,the clinical diagnosis was ABC.After operation,the patient was treated with 8 cycles of AC-T regimen adjuvant chemotherapy(The first four cycles were given pirarubicin 60 mg·m-2,cyclophosphamide 600 mg·m-2 per cycle;the last four cycles were given docetaxel 100 mg·m-2per cycle;every three weeks was a cycle of treatment),radiation therapy(The radiation dose was 50 Gy/25 f in the upper and lower part of the right collarbone and the tumor bed area,and after retract the tumor bed area was increased to 60 Gy)and endocrine therapy(Tamoxifen was administered at 20 mg per day).Results:The patient's breast color ultrasound and mammogram examination indicated that the right axillary mass of the patient was more likely to be malignant.The clinical diagnosis was right axillary ABC.According to the NCCN guide,the patient was treated with the standardized comprehensive treatment based on surgical treatment.16 months after operation,the patient recovered well and had a normal life.There was no upper limb dysfunction and no lateral upper limb lymphedema,and there were no recurrence or metastasis.Conclusion:ABC is extremely rarely seen in clinical practice.The clinical pathological features and treatment of ABC are similar to breast cancer.If there is no lesion in the mammary gland, it is not necessary to remove the mammary gland in the affected side.

Successful treatment of accessory breast cancer with endocrine therapy.

Accessory breast cancers in males are extremely rare, and only a few cases have been reported in the literature. In this paper, an 87-year-old male patient was diagnosed with an accessory breast cancer by means of computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography-computed tomography (PET-CT), and immunohistochemistry based on needle biopsy, and has undergone successful resection and postoperative adjuvant endocrine therapy. He was the oldest male patient with an accessory breast cancer reported in the Chinese Hospital Knowledge Database and PubMed literature from 1975 to 2015.

Male accessory breast cancer successfully treated with endocrine therapy: A case report.

Male accessory breast cancer is an extremely rare tumor. Several risk factors have been identified, including genetic and hormonal abnormalities. Accessory breast carcinoma usually occurs under the axilla or in the inguinal region. Clinical diagnosis is frequently delayed due to the general lack of awareness among physicians and patients. In the present study, the case of a 63-year-old male patient who was diagnosed with accessory breast cancer at a local advanced stage was reported. However, the patient was successfully treated with endocrine therapy.

Accessory breast cancer occurring concurrently with bilateral primary invasive breast carcinomas: a report of two cases and literature review.

The development of accessory breast tissue, which is found anywhere along the milk line, is attributed to the failure of milk line remnants to regress during embryogenesis. Primary tumors may arise from any ectopic breast tissue. Accessory breast cancer occurring concurrently with primary invasive breast cancer is extremely rare. Two such cases were reported in this article. One was a 43-year-old Chinese female who exhibited bilateral breast cancer (invasive ductal carcinoma, not otherwise specified, IDC-NOS) and an accessory breast carcinoma (IDC-NOS) incidentally identified in her left axilla. The ectopic breast tissue in her right axilla presented with adenosis. The patient was surgically treated, followed by postoperative docetaxel epirubicin (TE) chemotherapy. The second case was a 53-year-old Chinese female with bilateral breast cancer (apocrine carcinoma) accompanied by an accessory breast carcinoma (IDC-NOS) in her right axilla that was also incidentally identified. The patient was surgically treated after three doses of cyclophosphamide epirubicin docetaxel (CET) neoadjuvant chemotherapy, followed by adjuvant chemotherapy of the same regimen.

Clinicopathological Analysis of 38 Cases of Accessory Breast Cancer / 中国肿瘤临床

Objective: To study the clinicopathological characteristics，diagnosis，multiple modality therapy and prognosis of accessory breast cancer. Methods: Clinical data of 38 patients with accessory breast cancer seen in our hospital between October 1985 and November 2007. Results: The 38 cases of accessory breast cancer accounted for 0.15% of all 26,078 breast cancer cases during the same period.Six patients of stage Ⅰ and 3 patients of stage Ⅱ underwent breast-conserving local wide excision of the tumor plus axillary lymph node dissection,with the resection margins pathologically negative.The other 9 cases of stage Ⅱ patients were treated with Auchincloss mastectomy.Stage Ⅲ and stage Ⅳ patients were treated with Auchincloss or Halsted mastectomy.The most common histological type of accessory breast cancer was infiltrating ductal Carcinoma for 18 patients(47.4%)，of which 3 cases were associated with adenoma of the nipple tube.There were 6 cases of carcinoma simplex，6 cases of intraductal Carcinoma，3 cases of adenocarcinoma with focal squamous cancer cells differentiation，3 cases of medullary carcinoma，and 2 cases of mucinous adenocarcinoma.The most common pathological stages(according to AJCC staging of breast cancer,2002.6th edition)were stage Ⅱ and Ⅲ in 12 cases(31.6%)，stage Ⅰ in 6 cases，and stage Ⅳ in 8 cases.All patients were followed-up for 1 to 23 years.The median follow-up time was 6 years and 7 months，and the follow-up rate was 100%.Until November 2008，12 patients died of metastasis and the other 26 patients were still alive.The 5-year overall survival rate was 35.3%.significantly lower than that of breast cancer patients(66.8%).The 3-year survival rate was 77.8%.The 5-year disease free survivaI rate was 28.6%and the 3-year disease free survival rate was 63.6%. Conclusion: Accessory breast cancer is rarely seen but is aggressive.The diagnosis mainly depends on clinical characteristics，postoperative pathology and imaging examinations.Early diagnosis is essential.Surgery combined with other adjuvant therapies can improve patient survival.

Diagnosis and treatment of accessory breast cancer in 16 cases / 中国综合临床

Objective To investigate the clinicopathological characteristics,diagnosis and therapy,as well as the prognosis of accessory breast cancer. Methods Twenty-two cases were diagnosed as accessory breast cancer from Jan 1,1984 to Dec 31,2008, their clinicopatholgical data were analyzed retrospectively.Results Up to Mar. 1, 2010,2 cases had local recurrence;7 cases had long-distance metastasis;6 cases died. In the current study,the 5-year survival rate of accessory breast cancer was 43. 7%. Conclusions Accessory breast cancer is aggressive. The diagnosis was mainly based on clinical characteristics and postoperative pathology. The combined therapies may improve the survival rate.