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Print ISSN: 2754-3242 Online ISSN: 2754-1304
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November-December 2025 Volume 5 Issue 6

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Case Report Open Access

Accessory breast granulomatous mastitis: A case report and mini‑review of the literature

  • Authors:
    • Abdulwahid M. Salih
    • Ari M. Abdullah
    • Lana R.A. Pshtiwan
    • Sakar O. Arif
    • Zuhair D. Hammood
    • Shaban L. Tofiq
    • Hiwa O. Abdullah
    • Masty K. Ahmed
    • Harzal Hiwa Fatih
    • Meer M. Abdulkarim
    • Fahmi H. Kakamad

  • View Affiliations / Copyright

    Affiliations: Department of Scientific Affairs, Smart Health Tower, Sulaymaniyah 46001, Iraq, Department of Surgery, Tikrit Teaching Hospital, Tikrit, Saladin Governorate 34001, Iraq
    Copyright: © Salih et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
  • Article Number: 78
    |
    Published online on: October 23, 2025
       https://doi.org/10.3892/mi.2025.277
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Abstract

Granulomatous mastitis (GM) is a rare inflammatory condition that primarily affects the breasts, and its occurrence in accessory breast tissue is even rarer. The present report describes the case of a patient with GM in the accessory breast. A 43‑year‑old female patient presented with a 1‑month history of pain in the left axilla and breast. An analysis of her medical and surgical history did not reveal any notable findings, but she had a history of four full‑term pregnancies and a cumulative lactation period of 4 years. Upon a clinical examination, a palpable, ill‑defined, tender mass was noted along with an accessory breast and nipple in the axilla. The diagnosis was chronic mastitis, and she was treated with oral corticosteroids, amoxicillin, cabergoline and analgesics. Her condition initially improved; however, the symptoms recurred 1 year later. A wide local excision of the left axillary tail was performed. The patient experienced marked improvement post‑surgery and remained stable, with no recurrence, at the 1‑year follow‑up. In addition, in the present study, seven recent cases of GM were included for a brief literature review, involving patients aged 23 to 42 years. Of these cases, 6 cases did not have any notable medical histories. A total of 6 patients had a history of pregnancy, with an average lactation duration of 22.7 months. The right breast was affected in 6 cases. Pain and swelling were the most frequent symptoms. A conservative approach, which included antibiotics, corticosteroids and wound dressing was used for 5 patients. In total, 6 patients achieved recovery. On the whole, the present study demonstrates that accessory breast tissue can develop GM. While corticosteroids may provide favorable short‑term results, they do not necessarily prevent recurrence, whereas surgical management may provide more durable long‑term outcomes.
View Figures

Figure 1

Image of the axillary region illustrating an area of hyperpigmentation with an indurated appearance. A small, isolated sinus tract is visible, indicating underlying chronic inflammation. The affected region corresponds to the axillary tail of Spence, where ectopic breast tissue is present. The surrounding skin appears slightly thickened, with mild erythema suggesting an ongoing inflammatory process.

Figure 2

Grayscale ultrasound of the right axilla demonstrating accessory breast tissue with heterogeneous parenchymal echotexture and mild edema, consistent with mastitis. The numbers ‘1’ and ‘2’ designate the two orthogonal caliper sets used to measure the long- and short-axis of the lesion, respectively; the yellow crosses indicate the caliper endpoints. The recorded dimensions are 36x9 mm (long x short)

Figure 3

(A) Section of skin covered by benign epidermis (black arrows) with underlying tissue containing a lactiferous duct (red arrow). Hematoxylin and eosin staining; magnification, x4. (B) Higher magnification demonstrating multiple benign lactiferous ducts lined by ductal epithelial cells (black arrows). Hematoxylin and eosin staining; magnification, x10. (C) Section illustrating a benign lactiferous duct (black arrow) surrounded by tissue heavily infiltrated with mixed inflammatory cells and foamy macrophages (black stars). Hematoxylin and eosin staining; magnification, x4. (D) Higher magnification image illustrating multinucleated giant cells (black arrows) with ill-formed epithelioid histiocyte aggregates (red arrows) and dense mixed inflammatory cell infiltration (black star). Hematoxylin and eosin staining; magnification, x10.
View References

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Related Articles

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Copy and paste a formatted citation
Spandidos Publications style
Salih AM, Abdullah AM, Pshtiwan LR, Arif SO, Hammood ZD, Tofiq SL, Abdullah HO, Ahmed MK, Fatih HH, Abdulkarim MM, Abdulkarim MM, et al: Accessory breast granulomatous mastitis: A case report and mini‑review of the literature. Med Int 5: 78, 2025.
APA
Salih, A.M., Abdullah, A.M., Pshtiwan, L.R., Arif, S.O., Hammood, Z.D., Tofiq, S.L. ... Kakamad, F.H. (2025). Accessory breast granulomatous mastitis: A case report and mini‑review of the literature. Medicine International, 5, 78. https://doi.org/10.3892/mi.2025.277
MLA
Salih, A. M., Abdullah, A. M., Pshtiwan, L. R., Arif, S. O., Hammood, Z. D., Tofiq, S. L., Abdullah, H. O., Ahmed, M. K., Fatih, H. H., Abdulkarim, M. M., Kakamad, F. H."Accessory breast granulomatous mastitis: A case report and mini‑review of the literature". Medicine International 5.6 (2025): 78.
Chicago
Salih, A. M., Abdullah, A. M., Pshtiwan, L. R., Arif, S. O., Hammood, Z. D., Tofiq, S. L., Abdullah, H. O., Ahmed, M. K., Fatih, H. H., Abdulkarim, M. M., Kakamad, F. H."Accessory breast granulomatous mastitis: A case report and mini‑review of the literature". Medicine International 5, no. 6 (2025): 78. https://doi.org/10.3892/mi.2025.277
Copy and paste a formatted citation
x
Spandidos Publications style
Salih AM, Abdullah AM, Pshtiwan LR, Arif SO, Hammood ZD, Tofiq SL, Abdullah HO, Ahmed MK, Fatih HH, Abdulkarim MM, Abdulkarim MM, et al: Accessory breast granulomatous mastitis: A case report and mini‑review of the literature. Med Int 5: 78, 2025.
APA
Salih, A.M., Abdullah, A.M., Pshtiwan, L.R., Arif, S.O., Hammood, Z.D., Tofiq, S.L. ... Kakamad, F.H. (2025). Accessory breast granulomatous mastitis: A case report and mini‑review of the literature. Medicine International, 5, 78. https://doi.org/10.3892/mi.2025.277
MLA
Salih, A. M., Abdullah, A. M., Pshtiwan, L. R., Arif, S. O., Hammood, Z. D., Tofiq, S. L., Abdullah, H. O., Ahmed, M. K., Fatih, H. H., Abdulkarim, M. M., Kakamad, F. H."Accessory breast granulomatous mastitis: A case report and mini‑review of the literature". Medicine International 5.6 (2025): 78.
Chicago
Salih, A. M., Abdullah, A. M., Pshtiwan, L. R., Arif, S. O., Hammood, Z. D., Tofiq, S. L., Abdullah, H. O., Ahmed, M. K., Fatih, H. H., Abdulkarim, M. M., Kakamad, F. H."Accessory breast granulomatous mastitis: A case report and mini‑review of the literature". Medicine International 5, no. 6 (2025): 78. https://doi.org/10.3892/mi.2025.277
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