A 35-year-old woman in the Philippines recently discovered she had a rare condition resulting in milk leaking from her armpits – a phenomenon linked to the presence of “ectopic breasts,” or accessory mammary tissue. While seemingly unusual, this condition, known as polymastia, affects a small percentage of both men and women and can often be traced back to embryonic development.
Understanding the Condition: Polymastia and Ectopic Breast Tissue
The woman’s experience began with unexplained swellings in both armpits. The lumps, roughly the size of small apples, were skin-colored and irregularly shaped. Notably, these weren’t painful, and the skin over the lumps didn’t feel unusually warm. The condition’s emergence coincided with breastfeeding, and doctors observed milk droplets leaking from her hair follicles when the areas were gently squeezed.
This particular presentation points to a condition called polymastia, which involves the presence of additional breast tissue outside of the chest. In this case, the tissue manifested as accessory breasts within the armpits. These tissues originate from the mammary ridge, a line of thickening that develops in the womb. This ridge is where the initial structures of mammary glands form. Normally, the mammary ridge recedes during fetal development, leaving only the chest area where breasts typically develop. However, remnants of this ridge can sometimes persist, leading to the formation of ectopic breast tissue.
The Development and Location of Ectopic Breast Tissue
The mammary ridge extends from the armpit to the inner thigh, and persistent tissue along this line can appear in various locations, though the armpit is the most common site. Accessory breasts can also develop in the perineum (around the genitalia), groin, thigh, or vulva. In rare instances, the tissue can even take shape on the face or back. Intriguingly, this tissue can sometimes develop an areola and nipple.
A Recurring Pattern in This Patient’s Case
What made this particular case notable was the recurring pattern experienced by the patient. She reported similar swellings had appeared 15 years earlier, following the birth of her first child. The lumps subsided after she stopped breastfeeding, only to reappear with subsequent pregnancies. This cyclical nature further linked the condition to hormonal fluctuations associated with pregnancy and lactation.
Diagnosis and Treatment Considerations
After careful examination and a biopsy, doctors confirmed the diagnosis of polymastia. The biopsy results showed that the lumps were indeed composed of breast tissue. While surgical removal of the tissue was initially recommended, the patient chose to forgo surgery, based on her previous experience that the tissue typically shrinks when she stops breastfeeding.
This is a good example of how understanding a patient’s history and previous experiences can inform treatment decisions.
Instead, the doctors advised her to continue monitoring the areas for new swellings and to have them checked during routine breast cancer screenings. The condition is relatively common – affecting roughly 2% to 6% of women and 1% to 3% of men – but can be genetically linked in about 6% of cases. Notably, the patient reported no family history of similar conditions, making her case all the more unique. This highlights that while a genetic predisposition may exist, the condition can also occur sporadically.
