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Case Reports
. 2022 Sep 19;2022(9):rjac425.
doi: 10.1093/jscr/rjac425. eCollection 2022 Sep.

Locally advanced breast cancer arising in the axilla

Sasha Sapon-Cousineau  1 , Dan Moldoveanu  2 , Danielle Charpentier  3 , Alain Gagnon  3 , Érica Patocskai  3
Affiliations
Case Reports

Locally advanced breast cancer arising in the axilla

Sasha Sapon-Cousineau et al. J Surg Case Rep. .

Abstract

Locally advanced breast cancer arising from ectopic axillary breast tissue is an unusual presentation of this malignancy. The work-up and treatment approach pose some unique challenges. We present the case of a 37-year-old female presenting with a left axillary lesion with skin involvement. Radiological studies and biopsy demonstrated an underlying axillary mass compatible with a triple-positive invasive ductal carcinoma of the breast. Following neoadjuvant therapy, the patient underwent nipple-sparing mastectomy with wide local excision of the involved axillary skin and axillary lymph node dissection. Ectopic locally advanced breast cancer can be treated similarly to its orthotopic counterpart, favoring a neoadjuvant therapy approach followed by surgical excision. Special considerations include the local anatomy of the tumor, the extent of surgery and reconstructive options.

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Figures

Figure 1
Figure 1
(A) Appearance of the left axillary lesion at presentation. (B) Magnified view on mammogram of the left axilla showing an irregular mass with extension to the skin in the context of an ectopic mammary gland.
Figure 2
Figure 2
Breast MRI depicting (A) the known mass in a superficial axillary position with direct invasion of the overlying skin and dermal thickening, measured at 1.8 × 1.3 cm wide by 1.9 cm in height. The left axillary nodes appear more numerous and slightly enlarged but share no malignant features. (B) The left and right breast showing no sign of neoplasia.
Figure 3
Figure 3
Pre-operative appearance of the left axillary lesion (circled in black) following neoadjuvant therapy.
Figure 4
Figure 4
(A) Left nipple sparing mastectomy with axillary lymph node dissection and en-block skin excision and (B) pathological specimen containing from left to right: the total mastectomy, excised skin and axillary lymph node dissection.
See this image and copyright information in PMC

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