Unilateral axillary mass with pain after normal vaginal delivery
This article describes the case of a 26-year-old woman who presented with pain in the right armpit, two days after normal vaginal delivery. Physical examination was consistent with a round, firm, and well-circumscribed axillary mass. The mass also released white discharge on applying pressure. Based on the findings, doctors diagnosed the patient with polymastia. Polymastia is a condition in which accessory breast tissue develops along the former embryonic mammary ridge.
Milk draining from the milk tissue during the postpartum period can cause it to enlarge
Milk can drain from the milk tissue in the postpartum period causing it to enlarge. In some cases this can cause pain and discomfort. Axillary breast tissue is infrequently reported in literature with 2% to 6% of bilateral cases reported. The supernumerary breast tissue can be found along the milk line extending from the axilla to the pubic region. This is normal breast tissue that reacts to hormonal changes. The ectopic tissue usually becomes symptomatic during pregnancy and during the postpartum period when women begin breastfeeding. Swelling and pain are the most common complaints.
Diagnosis and treatment
Based on the clinical findings, doctors diagnosed the patient with polymastia or a unilateral axillary mass. Generally, the management is conservative with breast feeding cessation to allow the symptoms to regress. There have been cases where women have reported pain relief with pumping the axillary breasts. Differentials include suppurative hidradenitis, lymphadenopathy, and lipoma.
Although the condition is benign, it is likely to recur and even worsen with subsequent pregnancies. The breast tissue should be monitored for pathologic changes and malignanciy. In this case the patient was assured that the condition is benign and was advised for routine screening for breast cancer, including accessory tissue examination.
References
Axillary Mass after Delivery https://www.nejm.org/doi/full/10.1056/NEJMicm2033023
