How the accessory gland is formed
In the early stages of intrauterine development, along the sides of the embryo’s body there are thickenings of the ectoderm - milk lines, stretching from the armpits to the inguinal folds. Several pairs of mammary gland rudiments are laid on them. Normally, only one pair on the chest is preserved, the rest disappear. If some rudiment has not undergone reverse development, an accessory gland is formed. It can be full, with a nipple and areola, or it can be only glandular tissue without a nipple, which women often mistake for a wen or an inflamed lymph node.
- Full form - glandular tissue, nipple and areola
- Glandular tissue without a nipple is the most common option
- Only accessory nipple without gland
- Location along milk lines
- The most common location is the armpit
- Single-sided or double-sided arrangement
Symptoms
The accessory gland is subject to the same hormonal influences as the regular gland. Therefore, a characteristic sign is cyclicality: a few days before menstruation, the formation swells, becomes denser and more painful, and after it decreases. Many women first notice it during pregnancy or immediately after childbirth, when the tissue increases dramatically and milk may be released if there is a nipple. A large gland in the armpit interferes with wearing clothes, rubs, causes diaper rash and discomfort when moving the arm. Outside of hormonal surges, there may be no complaints at all.
- Soft lump in the armpit
- Swelling and soreness before menstruation
- Sharp increase during pregnancy and after childbirth
- Milk secretion in the presence of an accessory nipple
- Discomfort and rubbing from clothing
- Diaper rash in a skin fold
- Cosmetic discomfort
How can this be dangerous?
The main thing to understand is that the accessory gland is normal glandular tissue, which means that the same conditions can occur in it as in a normal breast. Fibroadenomas, cysts, mastitis during lactation and, less commonly, malignant tumors have been described. Due to their unusual location, such changes are often detected later than in the normal gland because less attention is paid to the axillary region during screening. Therefore, if there is a known accessory gland, it is worth informing the doctor about it before the examination and examining this area during self-examination.
- Mastitis during breastfeeding
- Fibroadenoma and cysts
- Mastopathic changes
- Malignant tumor - rare
- Late detection due to unusual location
- Engorgement and lactostasis in the postpartum period
Survey
The diagnosis is usually assumed upon examination based on the typical location and connection with the cycle. It is confirmed by an ultrasound examination, which shows glandular tissue similar in structure to a normal breast, and makes it possible to distinguish it from a lymph node, lipoma or cyst. Women over 40 years old are asked to include the axillary area during mammography. When identifying a node in the accessory gland, the same rules apply as for a normal breast: if the picture is suspicious, a biopsy is performed with histological examination.
- Examination by a mammologist with assessment of both axillary areas
- Ultrasound of soft tissues and mammary glands
- Mammography with axillary area
- Biopsy to identify a node
- Histological examination after removal
- Self-exam with armpit examination
Treatment
If the accessory gland does not bother you, treatment is not required - observation and inclusion of this area in routine mammological screening is sufficient. Removal is considered if there is severe pain, constant chafing, recurring inflammation, significant cosmetic discomfort, or if a mass is detected. The operation is simple: the tissue is excised through a small incision, and the material is sent for histology. Liposuction is sometimes used, but it only removes the fat component and is not suitable for the presence of nodes. For breastfeeding women, cold, support and medical supervision help with engorgement.
- Observation in the absence of complaints
- Surgical excision for pain and cosmetic discomfort
- Mandatory histology of removed tissue
- Treatment of accessory gland mastitis during lactation
- Skin care and diaper rash prevention
- Including the axillary region in regular screening