Giant Lactating Adenoma of the Breast: Safety and Benefits of Surgical Removal

Mohamed Ali Mlees; Aymen Mohamed Elsaka

doi:doi:10.11648/j.js.s.2017050301.21

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Giant Lactating Adenoma of the Breast: Safety and Benefits of Surgical Removal

Mohamed Ali Mlees, Aymen Mohamed Elsaka

Published in Journal of Surgery (Volume 5, Issue 3-1)

Received: 13 March 2017 Accepted: 14 March 2017 Published: 23 March 2017

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Abstract

Background and aim: Lactating adenoma is one of the benign tumors of breast that is frequently associated with pregnancy and lactation. Its size ranged from 1cm to 4 cm; however, rare cases with rapid postpartum enlargement up to 25 cm have been reported. Surgical removal of small lactating adenoma usually postponed till weaning, waiting for spontaneous regression and to avoid wound complications. The aim of this study was to assess the safety of surgical removal of giant (more than 5 cm) lactating adenomas during lactation, regarding wound complication specially milk fistula, with maintenance of breast feeding and its benefit. Patients and methods: The present study was conducted on 12 patients with giant lactating breast adenoma in Surgical Oncology unit at General Surgery Department, Tanta University Hospital from March 2013 to July 2016. The patients included in the study were lactating, had solitary breast mass more than 5 cm in size, had subjected to surgical removal through a cosmetic circumareolar or curvilinear incision. The patients resumed breast feeding within 24 hours, then followed-up for wound haematoma, wound seroma, wound infection, milk fistula, psychic and pain relief. Results: The patients' age ranged from 18 to 38 years with a mean age of 27 ± 3.6 years. In all patients; the chief complaint was cosmetically discomforting mass, asymmetry between the two breasts and fear of malignancy, pain was a presenting symptom in 6 patients. The size of the adenoma by ultrasound ranged from 8-18 cm with a mean of 12.6 cm. No wound complications were recorded. Conclusion: Giant lactating adenoma could be safely removed during lactation to alleviate pain, heaviness, and anxiety, to rule out malignancy or coexisting carcinoma with no wound complication, no milk fistula and good aesthetic outcome with maintenance of the breast feeding and its benefits.

Published in	Journal of Surgery (Volume 5, Issue 3-1) This article belongs to the Special Issue Minimally Invasive and Minimally Access Surgery
DOI	10.11648/j.js.s.2017050301.21
Page(s)	56-60
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Giant, Lactating Adenoma, Breast, Milk Fistula

References

[1]	Hicham El Fazazi, Youssef Benabdejlil, Mouna Achenani, Saida Mezane, Jaouad Kouach, Mohammed Oukabli: Lactating Adenoma: A case report. International Journal of Innovation and Applied Studies, 2014; 7 (4): 1671.
[2]	Amir A. Hamza, Saadeldin A. Idris: Lactating adenoma of the breast a diagnostic difficulty in pregnancy and rewarding natural history during lactation: A case report and review of literature. Medicine Journal, 2014; 1 (1): 13-16.
[3]	Mark E. Reeves, Arnold Tabuenca: Lactating adenoma presenting as a giant breast mass, Surgery 127 (5) (2000) 586–588.
[4]	De Brux J: Histopathologie du sein. Masson, edit. Paris 1979, 67-74.
[5]	Novotny D, Maygarden S, Shermer R, Frable W: Fine needle aspiration of benign and malignant breast masses associated with pregnancy. Acta Cytologica 1991; 35: 676-686.
[6]	O'Hara M, Page D: Adenomas of the breast and ectopic breast under lactational influences. Hum Pathol 1985; 16: 707-712.
[7]	Hertel BF, Zaloudek C, Kempson RL: Breast ad¬enomas. Cancer 1976; 37 (6): 2891–2905.
[8]	Slavin JL, Billson VR, Ostor AG: Nodular breast le¬sions during pregnancy and lactation. Histopathol¬ogy 1993; 22 (5): 481–485.
[9]	Behrndt VS, Barbakoff D, Askin FB, Brem RF: In¬farcted lactating adenoma presenting as a rapidly enlarging breast mass. AJR Am J Roentgenol 1999; 173 (4): 933–935.
[10]	Saglam A, Can B: Coexistence of lactating adenoma and invasive ductal adenocarcinoma of the breast in a pregnant woman. J Clin Pathol 2005; 58 (1): 87-89.
[11]	Magno S, Terribile D, Franceschini G, Fabbri C, Chiesa F, Di Leone A: Early onset lactating adenoma and the role of breast MRI: a case report. JMedCase Rep 2009; 3: 43.
[12]	James K, Bridger J, Anthony PP: Breast tumour of pregnancy ('lactating' adenoma). J Pathol 1988; 156 (1): 37-44.
[13]	Son EJ, Oh KK, Kim EK: Pregnancy-associated breast disease: radiologic features and diagnostic dilemmas. YonseiMedJ 2006; 47 (1): 34-42.
[14]	Parnes AN, Akalin A, Quinlan RM, Vijayaraghavan GR: AIRP best cases in radiologic-pathologic correlation: Lactating adenoma. Radiographics, 2013; 33 (2): 455-459.
[15]	Sabate JM, Clotet M, Torrubia S, Gomez A, Guerrero R, de las Heras P: Radiologic evaluation of breast disorders related to pregnancy and lactation. Radiographics 2007; 27 Suppl 1: S101-124.
[16]	Schackmuth EM, Harlow CL, Norton LW: Milk fistula: a complication after core breast biopsy. AJRAmJ Roentgenol 1993; 161 (5): 961-962.
[17]	Rodriguez AO, Chew H, Cress R, Xing G, McElvy S, DanielsenB: Evidence of poorer survival in pregnancy-associated breast cancer. Obstet Gynecol 2008; 112 (1): 71-78.
[18]	Kang Y, Kim SJ, Min J: Bromocriptine-treated giant lactating adenoma: a case report with imaging findings. Ultrasound in Obstetrics & Gynecology 2014; 44 (Suppl. 1): 367.

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Mohamed Ali Mlees, Aymen Mohamed Elsaka. (2017). Giant Lactating Adenoma of the Breast: Safety and Benefits of Surgical Removal. Journal of Surgery, 5(3-1), 56-60. https://doi.org/10.11648/j.js.s.2017050301.21

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Mohamed Ali Mlees; Aymen Mohamed Elsaka. Giant Lactating Adenoma of the Breast: Safety and Benefits of Surgical Removal. J. Surg. 2017, 5(3-1), 56-60. doi: 10.11648/j.js.s.2017050301.21

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AMA Style

Mohamed Ali Mlees, Aymen Mohamed Elsaka. Giant Lactating Adenoma of the Breast: Safety and Benefits of Surgical Removal. J Surg. 2017;5(3-1):56-60. doi: 10.11648/j.js.s.2017050301.21

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@article{10.11648/j.js.s.2017050301.21,
  author = {Mohamed Ali Mlees and Aymen Mohamed Elsaka},
  title = {Giant Lactating Adenoma of the Breast: Safety and Benefits of Surgical Removal},
  journal = {Journal of Surgery},
  volume = {5},
  number = {3-1},
  pages = {56-60},
  doi = {10.11648/j.js.s.2017050301.21},
  url = {https://doi.org/10.11648/j.js.s.2017050301.21},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.s.2017050301.21},
  abstract = {Background and aim: Lactating adenoma is one of the benign tumors of breast that is frequently associated with pregnancy and lactation. Its size ranged from 1cm to 4 cm; however, rare cases with rapid postpartum enlargement up to 25 cm have been reported. Surgical removal of small lactating adenoma usually postponed till weaning, waiting for spontaneous regression and to avoid wound complications. The aim of this study was to assess the safety of surgical removal of giant (more than 5 cm) lactating adenomas during lactation, regarding wound complication specially milk fistula, with maintenance of breast feeding and its benefit. Patients and methods: The present study was conducted on 12 patients with giant lactating breast adenoma in Surgical Oncology unit at General Surgery Department, Tanta University Hospital from March 2013 to July 2016. The patients included in the study were lactating, had solitary breast mass more than 5 cm in size, had subjected to surgical removal through a cosmetic circumareolar or curvilinear incision. The patients resumed breast feeding within 24 hours, then followed-up for wound haematoma, wound seroma, wound infection, milk fistula, psychic and pain relief. Results: The patients' age ranged from 18 to 38 years with a mean age of 27 ± 3.6 years. In all patients; the chief complaint was cosmetically discomforting mass, asymmetry between the two breasts and fear of malignancy, pain was a presenting symptom in 6 patients. The size of the adenoma by ultrasound ranged from 8-18 cm with a mean of 12.6 cm. No wound complications were recorded. Conclusion: Giant lactating adenoma could be safely removed during lactation to alleviate pain, heaviness, and anxiety, to rule out malignancy or coexisting carcinoma with no wound complication, no milk fistula and good aesthetic outcome with maintenance of the breast feeding and its benefits.},
 year = {2017}
}

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TY - JOUR
T1 - Giant Lactating Adenoma of the Breast: Safety and Benefits of Surgical Removal
AU - Mohamed Ali Mlees
AU - Aymen Mohamed Elsaka
Y1 - 2017/03/23
PY - 2017
N1 - https://doi.org/10.11648/j.js.s.2017050301.21
DO - 10.11648/j.js.s.2017050301.21
T2 - Journal of Surgery
JF - Journal of Surgery
JO - Journal of Surgery
SP - 56
EP - 60
PB - Science Publishing Group
SN - 2330-0930
UR - https://doi.org/10.11648/j.js.s.2017050301.21
AB - Background and aim: Lactating adenoma is one of the benign tumors of breast that is frequently associated with pregnancy and lactation. Its size ranged from 1cm to 4 cm; however, rare cases with rapid postpartum enlargement up to 25 cm have been reported. Surgical removal of small lactating adenoma usually postponed till weaning, waiting for spontaneous regression and to avoid wound complications. The aim of this study was to assess the safety of surgical removal of giant (more than 5 cm) lactating adenomas during lactation, regarding wound complication specially milk fistula, with maintenance of breast feeding and its benefit. Patients and methods: The present study was conducted on 12 patients with giant lactating breast adenoma in Surgical Oncology unit at General Surgery Department, Tanta University Hospital from March 2013 to July 2016. The patients included in the study were lactating, had solitary breast mass more than 5 cm in size, had subjected to surgical removal through a cosmetic circumareolar or curvilinear incision. The patients resumed breast feeding within 24 hours, then followed-up for wound haematoma, wound seroma, wound infection, milk fistula, psychic and pain relief. Results: The patients' age ranged from 18 to 38 years with a mean age of 27 ± 3.6 years. In all patients; the chief complaint was cosmetically discomforting mass, asymmetry between the two breasts and fear of malignancy, pain was a presenting symptom in 6 patients. The size of the adenoma by ultrasound ranged from 8-18 cm with a mean of 12.6 cm. No wound complications were recorded. Conclusion: Giant lactating adenoma could be safely removed during lactation to alleviate pain, heaviness, and anxiety, to rule out malignancy or coexisting carcinoma with no wound complication, no milk fistula and good aesthetic outcome with maintenance of the breast feeding and its benefits.
VL - 5
IS - 3-1
ER -

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Author Information

Mohamed Ali Mlees

Department of General Surgery, Surgical Oncology Unit, Faculty of Medicine, Tanta University, Tanta, Egypt
Aymen Mohamed Elsaka

Department of Pathology, Faculty of Medicine, Tanta University, Tanta, Egypt

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APA Style

Mohamed Ali Mlees, Aymen Mohamed Elsaka. (2017). Giant Lactating Adenoma of the Breast: Safety and Benefits of Surgical Removal. Journal of Surgery, 5(3-1), 56-60. https://doi.org/10.11648/j.js.s.2017050301.21

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ACS Style

Mohamed Ali Mlees; Aymen Mohamed Elsaka. Giant Lactating Adenoma of the Breast: Safety and Benefits of Surgical Removal. J. Surg. 2017, 5(3-1), 56-60. doi: 10.11648/j.js.s.2017050301.21

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AMA Style

Mohamed Ali Mlees, Aymen Mohamed Elsaka. Giant Lactating Adenoma of the Breast: Safety and Benefits of Surgical Removal. J Surg. 2017;5(3-1):56-60. doi: 10.11648/j.js.s.2017050301.21

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@article{10.11648/j.js.s.2017050301.21,
  author = {Mohamed Ali Mlees and Aymen Mohamed Elsaka},
  title = {Giant Lactating Adenoma of the Breast: Safety and Benefits of Surgical Removal},
  journal = {Journal of Surgery},
  volume = {5},
  number = {3-1},
  pages = {56-60},
  doi = {10.11648/j.js.s.2017050301.21},
  url = {https://doi.org/10.11648/j.js.s.2017050301.21},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.s.2017050301.21},
  abstract = {Background and aim: Lactating adenoma is one of the benign tumors of breast that is frequently associated with pregnancy and lactation. Its size ranged from 1cm to 4 cm; however, rare cases with rapid postpartum enlargement up to 25 cm have been reported. Surgical removal of small lactating adenoma usually postponed till weaning, waiting for spontaneous regression and to avoid wound complications. The aim of this study was to assess the safety of surgical removal of giant (more than 5 cm) lactating adenomas during lactation, regarding wound complication specially milk fistula, with maintenance of breast feeding and its benefit. Patients and methods: The present study was conducted on 12 patients with giant lactating breast adenoma in Surgical Oncology unit at General Surgery Department, Tanta University Hospital from March 2013 to July 2016. The patients included in the study were lactating, had solitary breast mass more than 5 cm in size, had subjected to surgical removal through a cosmetic circumareolar or curvilinear incision. The patients resumed breast feeding within 24 hours, then followed-up for wound haematoma, wound seroma, wound infection, milk fistula, psychic and pain relief. Results: The patients' age ranged from 18 to 38 years with a mean age of 27 ± 3.6 years. In all patients; the chief complaint was cosmetically discomforting mass, asymmetry between the two breasts and fear of malignancy, pain was a presenting symptom in 6 patients. The size of the adenoma by ultrasound ranged from 8-18 cm with a mean of 12.6 cm. No wound complications were recorded. Conclusion: Giant lactating adenoma could be safely removed during lactation to alleviate pain, heaviness, and anxiety, to rule out malignancy or coexisting carcinoma with no wound complication, no milk fistula and good aesthetic outcome with maintenance of the breast feeding and its benefits.},
 year = {2017}
}

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