How is ectopic breast tissue managed and treated?

From the Research

Ectopic breast tissue should be managed with surgical excision if symptomatic or causing cosmetic concerns, while asymptomatic cases often require only regular monitoring, as evidenced by the most recent study in 2022 1. The management of ectopic breast tissue depends on various factors, including symptoms, cosmetic concerns, and the risk of malignancy.

• Asymptomatic ectopic breast tissue often requires no treatment beyond regular monitoring, as the risk of malignancy is low, but still present, as shown in a case report from 2020 2.
• For symptomatic cases, surgical excision is the definitive treatment, involving complete removal of the aberrant tissue to prevent recurrence and allow for pathological examination, as demonstrated in a study from 2022 1.
• This procedure is typically performed under local or general anesthesia as an outpatient surgery, with minimal complications, such as an immediate postoperative hematoma, which did not require drainage in the study by 1.
• For patients experiencing pain or swelling during hormonal fluctuations, conservative management with NSAIDs like ibuprofen (400-600mg every 6-8 hours) or naproxen (250-500mg twice daily) can provide relief, as suggested by the example answer.
• Hormonal therapies such as oral contraceptives may help regulate symptoms in women whose ectopic tissue responds to hormonal changes, but this is not supported by the provided evidence.
• If malignancy is suspected based on changes in size, texture, or appearance, immediate medical evaluation is necessary, as ectopic breast tissue carries the same cancer risk as normal breast tissue, as highlighted in a case report from 2020 2.
• Patients should perform regular self-examinations of known ectopic tissue sites and include these areas in routine breast cancer screening protocols, as recommended by the example answer. The most recent and highest quality study, from 2022 1, provides evidence for the safety and effectiveness of surgical excision in adolescents with axillary ectopic breast tissue, with no recurrences observed after one year of follow-up.
• The study also recommends bilateral ultrasonography for preoperative diagnosis and excision through minimal incision, which seems to be safe and effective in this age group.
• The evidence from 2020 3 and 2011 4 supports the importance of clinical, radiological, and histological correlation in the approach of indeterminate soft-tissue tumors, with special focus on lesions in close proximity to the native breasts, where ectopic breast tissue should not be forgotten amongst differentials.
• The study from 1995 5 provides a review of the embryology, clinical presentation, diagnosis, treatment, and clinical significance of ectopic breast tissue, supernumerary breasts, and supernumerary nipples, but its recommendations are outdated compared to the more recent studies.