Peanut-sized lump on the lateral border of the pectoralis major

Introduction A peanut-sized mass at the lateral margin of the pectoralis major muscle is one of the clinical manifestations of breast cancer in the breast. Mammary of accessory mamma refers to a cancer that occurs in the accessory breast, which occurs mostly in the temporal region. The rare sites are the subclavian region, the abdomen, and the vulva region. Wang Faheng (1993) reported 4 cases of paraneoplastic breast cancer, including nipples, areola, and mammary glands. There are also only nipples, and some have lactation.

Cause

(1) Causes of the disease

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(two) pathogenesis

The premise of paraneoplastic breast cancer is that the accessory breast must have breast gland tissue, and the nipple or areola, or both, and the gland without the gland can not produce paracancerous breast cancer. Due to the presence of the glandular gland, during the physiological changes such as menstruation, pregnancy and lactation, there may be pain in the corresponding area and the breast, and even lactation with breast lactation. Therefore, the accessory breast with glands has the same possibility of developing breast cancer as the breast in the normal part.

1. The location of the disease: Paraneoplastic breast cancer can occur in any part of the axillary to groin "milk line", but it is most common in the vicinity of the breast outside the axilla, accounting for almost 90%.

2. Pathology: The accessory mammary gland is developed by the incomplete regression of the mammary gland. Its pathological structure and characteristics are not significantly different from those of normal breast, so its pathological type is the same as that of breast cancer.

an examination

Related inspection

External chest examination blood test

Course of disease: ranging from several months to several decades. More common in the axillary fossa, the left side is slightly more, mostly at the lateral edge of the pectoralis major, other parts are rare. Most of the masses are like peanuts. The larger ones are walnuts. They are hard and active, and the perimeter is unclear. The surface of the tumor is generally smooth, and a few can adhere to the skin or the base. The skin also has an "orange peel" that changes or ruptures. Local pain may occur and often radiate to the upper extremity of the chest and the affected side. The swelling of the mass during the menstrual period or pregnancy is obvious and painful, and the axillary lymph nodes may be swollen.

Differential diagnosis

Differential diagnosis of a mass of peanuts at the lateral margin of the pectoralis major:

1. Axillary lymphadenopathy: The phenomenon that the lymph nodes are enlarged due to internal cell proliferation or tumor cell infiltration, which is a common clinical sign. It can be found by touching the armpit area.

2, breast lumps: breast lumps usually refer to a disease caused by the formation of breast tissue due to different breast tissue. Breast lumps are the most common breast disorders, and many benign diseases are also manifested in the form of breast lumps, so the most important aspect of breast lumps is the distinction between benign and malignant. In addition to breast cancer is malignant, breast fibroadenomas, breast hyperplasia, breast cysts, breast fat necrosis and other lumps are benign, can be treated by acupoints and reflex zones massage. New lumps are present for the following reasons: cysts; nipple wounds are infected with bacteria; fibrocystic breast disease; benign tumors that do not spread. Hormonal abnormalities; suffering from malignant tumors.

3, subcutaneous emphysema: the subcutaneous tissue of the chest has a gas volume when it is called subcutaneous emphysema.

The course of disease varies from several months to several decades. More common in the axillary fossa, the left side is slightly more, mostly at the lateral edge of the pectoralis major, other parts are rare. Most of the masses are like peanuts. The larger ones are walnuts. They are hard and active, and the perimeter is unclear. The surface of the tumor is generally smooth, and a few can adhere to the skin or the base. The skin also has an "orange peel" that changes or ruptures. Local pain may occur and often radiate to the upper extremity of the chest and the affected side. The swelling of the mass during the menstrual period or pregnancy is obvious and painful, and the axillary lymph nodes may be swollen.

Due to the special location of the accessory breast, the diagnosis of the disease must meet the following conditions:

1. Pre-clavicular and subclavian cancer, clinical and histological examination of the breast tissue that is not associated with the normal site of the breast can be diagnosed with para-breast cancer.

2. When the histological examination of the axillary mass is cancer, the glandular lobular structure or intraductal cancer image must be seen around the cancer tissue to exclude metastasis.

3. The normal part of the breast is not cancerous, or associated with cancer of different histological types.

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