From the Guidelines
Accessory breast tissue can indeed be tender or painful, and its management should prioritize symptomatic relief and ruling out underlying malignancy. This extra breast tissue, which develops along the milk line from the armpit to the groin, responds to hormonal changes just like regular breast tissue, and its tenderness or pain can be exacerbated by menstrual cycles, pregnancy, or breastfeeding 1. The discomfort occurs because the tissue contains milk ducts and glandular components that swell and become sensitive with hormonal fluctuations.
Evaluation and Management
When evaluating persistent and severe breast pain, including that associated with accessory breast tissue, a comprehensive history and thorough clinical breast exam (CBE) are essential 1. If the CBE fails to identify any physical abnormality and screening mammograms are current and negative, symptomatic management can be initiated, including over-the-counter pain medications, use of a good support bra, and ice packs or heating pads 1. For focal breast pain, age-appropriate diagnostic imaging may be recommended, such as a diagnostic mammogram with or without ultrasound for those ≥30 years of age, and ultrasound for those <30 years of age 1.
Treatment Options
Treatment options for tender or painful accessory breast tissue include:
- Over-the-counter pain relievers like ibuprofen (200-400mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours) for mild discomfort
- Wearing supportive bras that fit properly to reduce pain
- Warm compresses applied to the area for 15-20 minutes for temporary relief For severe or persistent pain, or if there are concerns about underlying malignancy, medical evaluation is crucial, and surgical removal of the accessory breast tissue might be considered 1. It's essential to note that any new pain, increasing discomfort, or changes in accessory breast tissue should be evaluated by a healthcare provider to rule out other conditions.
From the Research
Accessory Breast Tissue Symptoms
- Accessory breast tissue can be asymptomatic or cause discomfort, including pain and tenderness, especially during menstruation 2, 3, 4
- The tissue can also cause cosmetic problems, anxiety, and restriction of arm movement 2, 3, 4
- Symptoms may be exacerbated during puberty and pregnancy 4
Characteristics of Accessory Breast Tissue
- Accessory breast tissue is found in up to 6% of the population, most commonly in the axilla along the "milk line" 5
- The tissue can occur anywhere along the mammary ridge, including the chest submammary area 6
- Accessory breast tissue can consist mainly of fatty tissue rather than mammary gland tissue, making it painless in some cases 6
Treatment of Accessory Breast Tissue
- Surgical excision, liposuction, or both can be used to treat accessory breast tissue 2, 3, 6, 4
- Reduction mammaplasty and removal of accessory breasts can be performed at the same time with no additional morbidity in patients with concomitant macromastia 2
- Liposuction is a simple and effective treatment for chest submammary accessory breast, which is often removed for cosmetic reasons 6