Breast: Anatomic Anomalies

Accessory Tissue

Polythelia (Supernumerary Nipples)

  • Definition: Additional Nipples
  • Occur Along the Milk Line from Axilla to the Groin
  • Most Common Site: Just Inferior to Normal Breast
  • May Be Associated with Renal Anomalies – Uncertain
  • Generally Asymptomatic
  • Treatment: Generally Requires No Intervention
    • Consider Surgical Excision for Patient Preference (Cosmesis)

Polythelia 1

Polythelia Milk Line 2

Polymastia (Accessory Breasts/Supernumerary Breasts)

  • Definition: Additional Accessory Breast Tissue
  • Most Common Site: Lower Axilla
  • Can Cause Painful Swelling During Pregnancy
  • Can Develop Tumors Similar to Normal Breast Tissue
  • Treatment: Generally Requires No Intervention
    • Consider Surgical Excision for Pain or if Tumor is Identified

Polymastia 3

Absent Tissue

Athelia

  • Definition: Absent Nipple
  • Treatment: Generally Requires No Intervention
    • Consider Corrective Surgery for Patient Preference (Cosmesis)

 

Athelia 4

Amastia

  • Definition: Absent Breast Tissue
  • Caused by Obliteration of the Milk Line During Embryogenesis
  • Unilateral Amastia is Associated with Poland Syndrome
  • Treatment: Generally Requires No Intervention
    • Consider Corrective Surgery for Patient Preference (Cosmesis)

Amastia 5

Poland Syndrome (Poland Sequence)

  • Presentation:
    • Chest Wall Hypoplasia (Breast & Pectoralis Muscle)
    • Symbrachydactyly (Fused, Missing or Shortened Digits)
  • Classically Unilateral
  • Due to Interruption in Utero Vascular Supply
  • Most Common in Men

Poland Syndrome: (A) Chest Wall Hypoplasia, (B) Symbrachydactyly 6

References

  1. Strnadberg E. Wikimedia Commons. (License: CC BY-SA-2.5)
  2. Seth S, Pandey P, Rawat R, Vishwakarma S. A rare areolar growth developing late in pregnancy. Indian Dermatol Online J. 2015 Jul-Aug;6(4):298-300. (License: CC BY-NC-SA-3.0)
  3. Duscher D, Kiesl D, Aitzetmüller M, Schmidt M, Huemer GM. Correction of Polymastia Vera Class I with Skin-sparing Mastectomy and Immediate Rib-sparing DIEP-Flap Reconstruction. Plast Reconstr Surg Glob Open. 2017 Jan 18;5(1):e1192. (License: CC BY-NC-ND-4.0)
  4. GOLDENRING H, CRELIN ES. Mother and daughter with bilateral congenital amastia. Yale J Biol Med. 1961 Jun;33(6):466-7. (License: CC Not Specified)
  5. Rodriguez IE, Heare T, Bruny J, Deleyiannis FW. Customized Titanium Implant for Chest Wall Reconstruction in Complex Poland Syndrome. Plast Reconstr Surg Glob Open. 2014 Feb;2(2):e112. (License: CC BY-NC-ND-3.0)
  6. Lizarraga KJ, De Salles AA. Multiple cavernous malformations presenting in a patient with Poland syndrome: A case report. J Med Case Rep. 2011 Sep 20;5:469. (License: CC BY-2.0)