Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-84b7d79bbc-dwq4g Total loading time: 0 Render date: 2024-07-25T14:06:34.566Z Has data issue: false hasContentIssue false

19 - Congenital malformations of the breast

from Part III - Thorax

Published online by Cambridge University Press:  08 January 2010

By
Younghoon R. Cho  and
Arun K. Gosain
Edited by
Mark D. Stringer ,
Keith T. Oldham  and
Pierre D. E. Mouriquand
Younghoon R. Cho
Affiliation:
Department of Plastic Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
Arun K. Gosain
Affiliation:
Department of Plastic Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
Mark D. Stringer
Affiliation:
University of Otago, New Zealand
Keith T. Oldham
Affiliation:
Children's Hospital of Wisconsin
Pierre D. E. Mouriquand
Affiliation:
Debrousse Hospital, Lyon
Get access

Summary

Introduction

The mammary glands begin their development early in organogenesis and progress through several developmental stages, both in the uterus and in subsequent life. From a biologic standpoint, the mammary glands serve as a source of nourishment and provide passive immunity to our offspring. From a social perspective, mammary glands serve as a means of nurturing these bonds between mother and infant. In addition, they play an important role in defining femininity and our perceptions of beauty and attraction.

The importance of normal breast development can be demonstrated further by the psychosocial impact that results when normal development is interrupted. Congenital breast malformations may become manifest at different stages of breast development. These can be characterized in terms of symmetry, shape variations, over- or underdevelopment, multiple sites of development, unilateral development, or absence of development. Abnormal breast development may affect either sex. In this chapter, we will discuss normal breast development in more detail as well as some of the more common congenital breast disorders encountered in the pediatric population.

Breast development

The development of the mammary glands is initially identical for both sexes, and is a result of complex interplay of growth factors including TGF-α, TGF-β1, tenascin-C and extracellular matrix proteins such as collagen IV during organogenesis. This interplay begins in the fourth week of gestation, when the human embryo measures between 4.5 and 6 mm.

Type
Chapter
Information
Pediatric Surgery and Urology
Long-Term Outcomes
 , pp. 242 - 252
Publisher: Cambridge University Press
Print publication year: 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Osin, P. P., Anbazhagan, R., Bartkova, J., Nathan, B., & Gusterson, B. A.Breast development gives insights into breast disease. Histopathology 1998; 33:275–283.CrossRefGoogle ScholarPubMed
Schmidt, I. M., Chellakooty, M., Haavisto, A.-M.et al.Gender difference in breast tissue size in infancy: correlation with serum estradiol. Pediatr. Res. 2002; 52:682–686.CrossRefGoogle ScholarPubMed
Huffman, J. W., Dewhurst, C. J., & Caprano, V. J. (eds.) The Gynecology of Childhood and Adolescence. 2nd edn. Philadelphia: W. B. Saunders Co., 1981.Google Scholar
Mehes, K.Association of supernumerary nipples with other anomalies. J. Pediatr. Surg. 1979; 95:274–275.Google ScholarPubMed
Rahbar, F.Clinical significance of supernumerary nipples in black neonates. Clin. Pediatr. 1982; 21:46–47.CrossRefGoogle ScholarPubMed
Mimouni, F., Merlob, P., & Reisner, S. H.Occurence of supernumerary nipples in newborns. Am. J. Dis. Child. 1983; 137:952–953.Google Scholar
Jaber, L. & Merlob, P.The prevalence of supernumerary nipples in Arab infants and children. Eur. J. Pediatr. 1988; 147:443.CrossRefGoogle ScholarPubMed
Schmidt, H.Supernumerary nipples: prevalence, size, sex and side predilection – a prospective clinical study. Eur. J. Pediatr. 1998; 157:821–823.CrossRefGoogle ScholarPubMed
Merlob, P.Congenital malformation and developmental changes of the breast: a neonatological view. J. Pediatr. Endocrinol. Metab. 2003; 16:471–485.CrossRefGoogle ScholarPubMed
Leung, A. K. & Robson, W. L.Polythelia. Int. J. Dermatol. 1989; 28:429–433.CrossRefGoogle ScholarPubMed
Armoni, M., Filk, D., Schlesinger, M., Pollak, S., & Metzker, A.Accessory nipples: any relationship to urinary tract malformation?Pediatr. Dermatol. 1992; 9:239–240.CrossRefGoogle ScholarPubMed
Hanson, E. & Segovia, J.Dorsal supernumerary breast. Case report. Plast. Reconstr. Surg. 1978; 61:441–445.CrossRefGoogle ScholarPubMed
Schewach-Millet, M. & Fisher, B. K.Supernumerary nipple on the shoulder. Cutis 1976; 17:384–385.Google Scholar
Toumbis-Joannou, E. & Cohen, P. R.Familial polythelia. J. Am. Acad. Dermatol. 1994; 30:667–668.CrossRefGoogle Scholar
Urbani, C. E. & Betti, R.Sporadic unilateral intra-areolar polythelia. Acta. Dermatol. Venerol. 1996; 76:156.Google ScholarPubMed
Shewnake, S. W. & Izuno, G. T.Supernumerary areolae. Arch. Dermatol. 1977; 113:823–825.CrossRef
Schwager, R. C., Smith, J. W., Gray, G. F., & Goulian, D. J.Inversion of the human female nipple, with a simple method of treatment.Plast. Reconstr. Surg. 1984; 54:164–168.Google Scholar
Park, H. S., Yoon, C. H., & Kim, H. J.The prevalence of congenital inverted nipples. Aesth. Plast. Surg. 1999; 23:144–146.CrossRefGoogle Scholar
Shafir, R., Bonne-Tamir, B., Ashbel, S., Tsur, H., & Goodman, R. M.Genetic studies in a family with inverted nipples (mammillae invertita). Clin. Genet. 1979; 15:346–350.CrossRefGoogle Scholar
Lee, K. Y. & Cho, B. C.Surgical correction of inverted nipples using the modified Namba or Teimourian technique. Plast. Reconstr. Surg. 2004; 113:328–336.CrossRefGoogle ScholarPubMed
Scholten, E.A contemporary correction of inverted nipples. Plast. Reconstr. Surg. 2001; 107:551–513.CrossRefGoogle ScholarPubMed
Trier, W. C.Complete breast absence: case report and report of literature. Plast. Reconstr. Surg. 1965; 36:431–439.CrossRefGoogle ScholarPubMed
Tawil, H. M. & Najjar, S. S.Congenital absence of the breasts. J. Pedriatr. 1968; 73:751–753.CrossRefGoogle ScholarPubMed
Rosen, P. P.Rosen's Breast Pathology. 2nd edn. Philadelphia: Lippincott Williams & Wilkins, 2001.Google Scholar
Leung, W., Heaton, J. P. W., & Morales, A.An uncommon urologic presentation of a supernumerary breast. Urology 1997; 50:122–124.CrossRefGoogle ScholarPubMed
Carlson, H. E.Gynecomastia. N. Engl. J. Med. 1980; 303:795–759.CrossRefGoogle ScholarPubMed
Anderson, J. A. & Gram, J. B.Male breast at autopsy. Acta. Pathol. Microbiol. Immunol. Scand. 1982; 90:191–197.Google Scholar
McGrath, M. H.Gynecomastia. St. Louis: CV Mosby, 1990.Google Scholar
Scheike, O., Visfeldt, J., & Petersen, B.Male breast cancer. 3. Breast carcinoma in association with the Klinefelter syndrome. Acta Pathol. Microbiol. Immunol. Scand. 1973; 81:352–358.Google ScholarPubMed
Webster, G. V.Gynecomastia in the Navy. Milit. Surg. 1944; 95:375–379.Google Scholar
Simon, B. E., Hoffman, S., & Kahn, S.Classification and surgical correction of gynecomastia. Plast. Reconstr. Surg. 1973; 51:48–52.CrossRefGoogle ScholarPubMed
Gurunluoglu, R. & Gurunluoglu, A.Paulus Aegineta, a seventh century encyclopedist and surgeon: his role in the history of plastic surgery. Plast. Reconstr. Surg. 2001; 108:2072–2079.CrossRefGoogle ScholarPubMed
Teimourian, B. & Pearlman, R.Surgery for gynecomastia. Aesth. Plast. Surg. 1983; 7:155–157.CrossRefGoogle ScholarPubMed
Courtiss, E. H.Gynecomastia: analysis of 159 patients and current recommendations for treatment. Plast. Reconstr. Surg. 1987; 79:740–753.CrossRefGoogle Scholar
Rosenberg, G. J.Gynecomastia: suction lipectomy as a contemporary solution. Plast. Reconstr. Surg. 1987; 80:379–386.CrossRefGoogle ScholarPubMed
Rohrich, R. J., Ha, R. Y., Kenkel, J. M., & Adams, W. P. Jr.Classification and management of gynecomastia: defining the role of ultrasound-assisted liposuction. Plast. Reconstr. Surg. 2003; 111:909–923.CrossRefGoogle ScholarPubMed
Letterman, G. & Schurter, M.Gynecomastia. St Louis: CV Mosby, 1982.Google Scholar
LeJour, M.Vertical mammaplasty and liposuction of the breast. Plast. Reconstr. Surg. 1994; 94:100–114.CrossRefGoogle ScholarPubMed
Blomqvist, L., Eriksson, A., & Brandberg, Y.Reduction mammaplasty provides long-term improvement in health status and quality of life. Plast. Reconstr. Surg. 2000; 106:991–997.CrossRefGoogle ScholarPubMed
Corriveau, S. & Jacobs, J. S.Macromastia in adolescence. Clin. Plast. Surg. 1990; 17:151–160.Google ScholarPubMed
O'Hare, P. M. & Frieden, I. J.Virginal breast hypertrophy. Pediatr. Dermatol. 2000; 17:277–281.CrossRefGoogle ScholarPubMed
Collins, E. D., Carolyn, L. K., Kim, M.et al.The effectiveness of surgical and nonsurgical interventions in relieving the symptoms of macromastia. Plast. Reconstr. Surg. 2002; 109:1556–1566.CrossRefGoogle ScholarPubMed
Poland, A.Deficiency of the pectoral muscles. Guys Hosp. Rep. 1841; 6:191.Google Scholar
DerKaloustia, V. M., Hoyme, H. E., Hogg, H., Entin, M. A. & Guttmacher, A. E. Possible common pathogenetic mechanisms for Poland sequence and Adams-Oliver syndrome. Am. J. Med. Gen. 1991; 38:69–73.CrossRefGoogle Scholar
Bouvert, J-P, Leveque, D., Bernetieres, F., & Gros, J. J.Vascular origin of Poland syndrome? A comparative rheographic study of the vascularization of the arms in eight patients. Eur. J. Pediatr. 1978; 128:17–26.Google Scholar
Bavinck, J. N. B. & Weaver, D. D.Subclavian artery supply disruption sequence: hypothesis of a vascular etiology for Poland, Klippel–Feil, and Mobius anomalies. Am. J. Med. Genet. 1986; 23:903.CrossRefGoogle ScholarPubMed
Issaivanan, M., Virdi, V. S., & Parmar, V. R.Subclavian artery supply disruption sequence–Klippel–Feil and Mobius anomalies. Ind. J. Pediatr. 2002; 65:441–442.CrossRefGoogle Scholar
Longaker, M. T., Glat, P. M., Colen, L. B., & Siebert, J. W.Reconstruction of breast asymmetry in Poland's chest-wall deformity using microvascular free flaps. Plast. Reconstr. Surg. 1997; 99:429–436.CrossRefGoogle ScholarPubMed
Spear, S. L., Pelletiere, C. V., Lee, E. S., & Grotting, J. C.Anterior thoracic hypoplasia: a separate entity from Poland syndrome. Plast. Reconstr. Surg. 2004; 113:69–77.CrossRefGoogle ScholarPubMed
Hester, T. R. J. & Bostwick, J.3rd. Poland's syndrome: correction with latissimus muscle transposition. Plast. Reconstr. Surg. 1982; 69:226–233.CrossRefGoogle ScholarPubMed
Ohmori, K. & Takada, H.Correction of Poland's pectoralis major muscle anomaly with latissimus dorsi musculocutaneous flaps. Plast. Reconstr. Surg. 1980; 65:400–404.CrossRefGoogle ScholarPubMed
Corso, P. F.Plastic surgery for the unilateral hypoplastic breast. A report of eight cases. Plast. Reconstr. Surg. 1972; 50:134–141.CrossRefGoogle ScholarPubMed
Mestak, J., Zadorozna, M., & Cakrtova, M.Breast reconstruction in women with Poland's syndrome. Acta Chir. Plast. 1991; 33:137–144.Google ScholarPubMed
Fujino, T., Harashina, T., & Aoyagi, F.Reconstruction for aplasia of the breast and pectoral region by microvascular transfer of a free flap from the buttock. Plast. Reconstr. Surg. 1975; 56:178–181.CrossRefGoogle ScholarPubMed
Rees, T. D. & Aston, S.The tuberous breast. Clin. Plast. Surg. 1976; 3:339–347.Google ScholarPubMed
Vecchione, T. R.A method for recontouring the domed nipple. Plast. Reconstr. Surg. 1976; 57:30–32.CrossRefGoogle ScholarPubMed
Mandrekas, A. D., Zambacos, G. J., Anastasopoulos, A., Hapsas, D., Lambrinaki, N., & Ioannidou-Mouzaka, L.Aesthetic reconstruction of the tuberous breast deformity. Plast. Reconstr. Surg. 2003; 112:1099–1108.CrossRefGoogle ScholarPubMed
Toranto, I. R.Two-stage correction of tuberous breast. Plast. Reconstr. Surg. 1981; 67:642–646.CrossRefGoogle Scholar
Atiyeh, B. S., Hashim, H. A., El-Douaihy, Y., & Kayle, D. I.Perinipple round-block technique for correction of tuberous/tubular breast deformity. Aesth. Plast. Surg. 1998; 22:284–288.CrossRefGoogle ScholarPubMed
Ribeiro, L., Canzi, W., Buss, A. Jr., & Accorsi, A. Jr.Tuberous breast: a new approach. Plast. Reconstr. Surg. 1998; 101:42–50.CrossRefGoogle ScholarPubMed
Grolleau, J. L., Lanfrey, E., Lavigne, B., Chavoin, J. P., & Costagliola, M.Breast base anomalies: treatment strategy for tuberous breasts, minor deformities, and asymmetry. Plast. Reconstr. Surg. 1999; 104:2040–2048.CrossRefGoogle ScholarPubMed
Puckett, C. L. & Concannon, M. J.Augmenting the narrow-based breast: the unfurling technique to prevent the double-bubble deformity. Aesth. Plast. Surg. 1990; 14:15–19.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×