MASTOPATHY OF THE ACCESSORY BREAST IN THE BILATERAL AXILLARY REGIONS OCCURRING CONCURRENTLY WITH ADVANCED BREAST-CANCER

We herein report a 41-year-old Japanese woman who demonstrated advance d cancer in the left breast occurring concurrently with mastopathy of the accessory breast tissue in the bilateral axillary regions, which a ppeared to be metastatic lymphadenopathy. A preoperative examination, including a mammogram, US, and CT, did not provide us with a definite diagnosis of the axillary masses: it was essential to diagnose the mas ses preoperatively since a bilateral mastectomy with nodal dissection is called for if the right axillary masses are metastatic from a cance r in the right breast. An intraoperative cytological examination from the bilateral axillary masses revealed adenosis with fibrocystic chang es in the accessory breast tissue. We therefore performed a modified r adical mastectomy only on the left side. The patient was thus saved fr om an unnecessary mastectomy of the right breast. Based on our experie nce, we wish to emphasize that the accessory breast tissue should be c onsidered for a differential diagnosis when evaluating the axillary ma sses in order to avoid over-surgery, especially when a patient has bee n diagnosed to have massive breast cancer. An intraoperative cytologic al examination is strongly recommended to reach a final diagnosis in s uch confusing cases.