Background: Postpartum axillary masses present a broad surgical differential, including lymphadenopathy, soft tissue neoplasms, and hormonally responsive lesions. Ectopic breast tissue, although uncommon, may undergo rapid lactation-associated enlargement and mimic pathologic masses requiring operative evaluation. Surgical management may also lead to unique complications, such as axillary web syndrome (AWS).
Case Presentation: A 25-year-old G3P3 woman presented two days postpartum with a painful, rapidly enlarging 10 cm left axillary mass. The mass had been present since adolescence with cyclic tenderness, and it had similarly enlarged and regressed during previous postpartum periods. Examination revealed a firm, mobile, dome-shaped mass concerning for lymphatic, lipomatous, or neoplastic processes. Given the hormonally driven postpartum recurrence, ectopic mammary tissue was strongly suspected. Conservative therapy provided partial relief, but symptoms persisted.
Management and Outcome: Definitive excision was performed after lactation ceased. Histopathology confirmed ectopic breast tissue with benign ductal hyperplasia and cystic change. Postoperatively, the patient developed axillary web syndrome, presenting as a painful, cord-like band restricting shoulder abduction, which improved with physical therapy. She recovered fully.
Conclusion: Ectopic breast tissue should be considered in reproductive-age patients presenting with postpartum axillary masses. Awareness of hormonally triggered enlargement and potential postoperative complications such as AWS can optimize surgical planning, patient counseling, and postoperative rehabilitation.
Case Presentation: A 25-year-old G3P3 woman presented two days postpartum with a painful, rapidly enlarging 10 cm left axillary mass. The mass had been present since adolescence with cyclic tenderness, and it had similarly enlarged and regressed during previous postpartum periods. Examination revealed a firm, mobile, dome-shaped mass concerning for lymphatic, lipomatous, or neoplastic processes. Given the hormonally driven postpartum recurrence, ectopic mammary tissue was strongly suspected. Conservative therapy provided partial relief, but symptoms persisted.
Management and Outcome: Definitive excision was performed after lactation ceased. Histopathology confirmed ectopic breast tissue with benign ductal hyperplasia and cystic change. Postoperatively, the patient developed axillary web syndrome, presenting as a painful, cord-like band restricting shoulder abduction, which improved with physical therapy. She recovered fully.
Conclusion: Ectopic breast tissue should be considered in reproductive-age patients presenting with postpartum axillary masses. Awareness of hormonally triggered enlargement and potential postoperative complications such as AWS can optimize surgical planning, patient counseling, and postoperative rehabilitation.