DIFFERENTIAL-DIAGNOSIS OF AXILLARY MASSES

Axillary masses are uncommon alterations when detected as an isolated finding. We evaluated 31 patients with isolated axillary masses. Patie nts with alterations of the breasts or the upper limbs or with ipsilat eral chest lesions were excluded from the study. Nine patients had occ ult breast cancer, 5 of them in the contralateral breast. Seven had me tastatic lymph nodes of non-ductal origin, and 1 had carcinoma of apoc rine cells with metastasis to the axilla. Four patients had benign lym phadenopathy which disappeared spontaneously, and 4 others had rupture d infundibular follicular cyst, nodular fibromatosis, inflammatory tub erculous and inflammatory rheumatoid lymphadenitis. Five had an ectopi c breast (2 with a fibroadenoma and 3 with fibrocystic changes). One p atient had an axillary lipoma. The mean age of patients with malignant pathology was 55.1 +/- 10.9 years, and the mean age of patients with a benign pathology was 43.1 +/- 14.7 (P<0.01). Chest X-ray and bilater al mammography are useful when the cause of the mass cannot be determi ned by taking a detailed history of neoplastic or infectious anteceden ts, by careful physical examination of the skin of the arms, trunk and neck, or by palpation of the breasts and thyroid. Fine needle aspirat ion biopsy distinguishes between benign and malignant pathologies. In cases of indeterminate neoplasia, complete axillary dissection for dia gnosis is indicated.