Polymastia is an aesthetic condition characterized by the presence of additional breasts. The extra breast can appear in many forms, from a fully functional third breast or just a small lump of breast tissue with or without nipple or areola. It can be found in any part of the body, such as on the armpit, neck, vulva or even the foot. Similar to a natural breast, they also experience sensitivity to hormonal (estrogen) changes, leading to breast enlargement. If the supernumerary breast is along the milk line where mammary glands are, it can also lactate during nursing. While it is usually a matter of an extra breast, there are people who Were born with four or more breasts. Apart from being aesthetically displeasing, this condition does not pose any underlying medical condition but is frequently misdiagnosed as lipoma, which is a benign tumor that is made up fat cells. The incidence of having extra breast is less common than having extra nipples (polythelia).
polythelia- A supernumerary nipple (also known as a third nipple, triple nipple, accessory nipple,polythelia or the related condition: polymastia) is an additional nipple occurring in mammals, including humans. Often mistaken for moles, supernumerary nipples are diagnosed in humans at a rate of approximately 1 in 3 males[dubious ] and 1 in 17 females
The nipples appear along the two vertical “milk lines,” which start in the armpit on each side, run down through the typical nipples and end at the groin. They are classified into eight levels of completeness from a simple patch of hair to a milk-bearing breast in miniature.
Polythelia refers to the presence of an additional nipple alone while polymastia denotes the much rarer presence of additional mammary glands.
Although usually presenting on the milk line, pseudomamma can appear as far away as the foot.
A possible relationship with mitral valve prolapse has been proposed.
Polymastia (supernumerary breasts) is a relatively common congenital condition in which abnormal accessory breast tissue is found in addition to normal breast tissue. However, it may not be evident until puberty.Although accessory breast tissue is usually found along the thoracoabdominal region of the milk line (67%), which extends down to the groin, ectopic breast tissue may also be present in locations such as the face, back, and thigh.
About 2% to 6% of females and 1% to 3% of males are affected by this condition, a third of whom have more than one area of supernumerary tissue growth. Occurrence rates vary widely on the basis of ethnicity and gender, ranging from as low as 0.6% in Caucasians to as high as 5% in Japanese females.
Symptoms include swelling and tenderness of the affected region, thickening of the axilla and limited range of shoulder motion, and irritation from clothing. These symptoms are usually worsened by the onset of puberty and pregnancy. Supernumerary breast tissue also develops during this period alongside normal breast tissue growth.
Polymastia was categorized in 1915 by Kajava, whose classification system still remains in use today.
The development of breast neoplasm in ectopically located glandular tissue has been depicted. Madej et al،describe a rare case of a 50-year-old woman who, in spite of undergoing regular mammography screening, developed an invasive accessory breast cancer. On physical examination, a 2-cm tumor located 4 cm below the left inframammary fold was detected, which infiltrated the thoracic wall. Biopsy revealed an invasive stage IIIB ductal breast cancer. The patient was managed by chemotherapy and surgical excision. The authors advocate that a diagnosis of accessory breast cancer be made by physical examination and ultrasonography. When a diagnosis of symptomatic accessory breast is made, preventive resection of accessory breast may be the treatment of choice.
There are many possible treatments to correct polymastia; however, it is generally recommended that accessory breast tissue be excised.Sadove and van Aalstreported that when compared to other congenital and acquired breast anomalies, correction of polymastia with breast reduction techniques required the least number of operations per patient. To assess the surgical treatment of axillary accessory breast tissue, Aydogan et alperformed a retrospective analysis of 29 patients over a period of 8 years, of which 16 patients had unilateral and 13 patients had bilateral accessory breasts; 21 patients underwent excision of breast tissue, 5 had liposuction, and 3 had both. It was reported that excision, liposuction, or both resulted in satisfactory outcomes. Fan describes an alternative tumescent liposuction technique to prevent the occurrence of the central depression appearance that is often left as a result of the adjacent fat tissue remnant following the traditional methods of resecting the accessory breast tissue. This alternative approach may result in minimal scarring and better contour than can be obtained by conventional methods.
Regardless of the technique utilized, attempts at removing accessory breast tissue can lead to surgical complications such as contour irregularities, seromas, and possibly recurrence. Large resections often benefit from postoperative drain usage.