Lactating Adenoma A Case Report

Volume 8, Issue 2, February – 2023 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
Lactating Adenoma: A Case Report

Wakama I E, Fubara B N Eli S.,Okagua KE Ocheche U.
Department of Surgery,Rivers State Department of Obstetrics and Department of Obstetrics and
University Teaching Gynaecology, Rivers State Gynaecology, Pamo Unversity of
Hospital University Teaching Hospital Medical Sciences
Correspondence: Dr Eli S MBBS, FWACS
Abstract: II. CASE PRESENTATION

Background: Lactating adenoma are rare benign
stromal breast tumors that typically occur in the peri- She was Mrs AC 26-year old primipara who presented
partum period. They are prevalent breast tumours at 27 weeks gestational age with a two-month history of a
during pregnancy and lactation due to breast rapidly growing swelling in her left breast, The swelling was
enlargement and hormonal changes. associated with a feeling of heaviness and the patient was
embarrassed by the disparity in the breast sizes. She had no
Aim: To present this rare clinical entity and offer family history of breast or other malignancies.
management option
On examination the left breast was markedly larger
Case report: She was Mrs A.C a 25 year old primipara than the right with edema and visible veins There was a
who presented at 8 weeks post-partum at the Surgical huge, firm and mobile mass occupying most of both lower
outpatient clinic of the Rivers State University Teaching quadrants of the breast causing marked asymmetry. The
Hospital with a breast swelling. She was first seen at 27 mass that was warm, not tender, well defined and
weeks gestation when she declined surgical intervention. approximately12 cm in diameter. There was no axillary
On physical examination she had a right non-tender lymphadenopathy. The abdominal examination was normal
breast mass which measured 8 centimeter (cm) by 6 and in accordance with her gestational age.
centimeter (cm). She declined immediate surgery and
was commenced on bromocptine. An excellent response A working diagnosis of a malignant phyllodes tumor
with shrinkage was elicited She had a successful left was made on the basis of rapid growth and absence of
breast lump excision and vertical mammoplasty with lymphadenopathy.
anterior and superior pedicles under general anesthesia.
Histology revealed lactating adenoma. She was Breast ultrasound revealed a huge heterogenous solid/
cystic hypoechoic mass measuring 9.6 x 8.5cm spanning
discharged on her 4th post-operative day in good
from 3to 9o’clocklower quadrants. Skin and soft tissues
clinical condition. She had an excellent cosmetic result
and was in a satisfactory clinical state on subsequent were engorged and thickened.
follow-up visits at the surgical outpatient clinic. An urgent core biopsy was done which showed
proliferation of variablydilated small and medium sized
Conclusion: Lactating adenoma is a rare clinical entity.
High index of suspicion should be entertained for ducts lined by columnar cells with supranuclear cytoplasm
patients presenting with this breast tumour with prompt The ducts were filled with pinkish secretions, In addition to
diagnosis and as surgical intervention produces this were enlarged mammary nodules and a normocellular
favourable outcome. stroma. There was no evidence of malignancy. The
histological diagnosis was consistent with lactating
Keywords:- lactating, adenoma, vertical, mamoplasty, adenoma.
anterior, superior, pedicles. Bromociptine.
In the interval to receipt of histopathology report the
I. INTRODUCTION mass grew even larger. Our patient was offered immediate
surgery but she declined due to apprehension in view of her
Lactating adenoma are rare benign stromal breast pregnant state. After counselling she was now commenced
tumors that typically occur in the peri-partum period.1 They on oral Bromocriptine 2,5 mg twice daily, Close home
are prevalent breast tumors during pregnancy and lactation monitoring of her blood pressure was undertaken, A gradual
due to breast enlargement and hormonal changes. 1,2 lactating reduction in size of the mass and breast was observed.
adenoma are usually slow growing and smaller than 3cm in
maximum diameter.3,4 Our patient had a spontaneous vertex delivery of a live
female at 39 weeks of gestation without complication. She
Rare cases of giant lactating adenoma with rapid elected to continue with bromocriptine and began formula
antepartum enlargement or antepartum surgical feeding due to suppressed lactation.
management.
IJISRT23FEB074 www.ijisrt.com 2254

ISSN No:-2456-2165
At 8 weeks post-partum, surgery was undertaken under lactatingadenoma She was discharged on her 4th post
general anaesthesia, The lump was excised enbloc. The operative day without complications. Three weeks later she
residual ptotic breast was reconstructed with a superior and was fully healed and delighted with the surgical outcome.
inferior bipedicle vertical mammoplasty including nipple She rated the cosmetic result as excellent, Subsequent visits
areolar complex reduction and elevation, The surgical at three and six months pot surgery revealed sustained
specimen weighed 233g, and histopathology confirmed satisfaction.
Fig. 1: Lactating Adenoma Prior To Surgery
Fig. 2: Lactating Adenoma Post-Surgery

ISSN No:-2456-2165
III. DISCUSSION [6.] Layton C, Starhei M, Colladu - Mesa F, Eli Avisar.
Exceedingly rare lactating adenoma of 3 -year
Our patients Mrs. AC presented with lactating duration: a case report.
adenoma eight weeks post partum thus tumour is a rare Https://abs.amegroups.com>html(accessed
benign breast tumour.2 Diagnosis of this tumour needs to be (1/2/2023).
distinguished from breast cancer, a common diagnosed [7.] Olfatbakhsh A, Gholizadeh Z, Beheshtiyan T,
malignancy in pregnancy.2 In addition, it is note worthy that Hoseinpoow P. Five - year study of patients with
rare cases of giant lactating adenomas with rapid growth Lactating Adenoma and Review of the Literature
post – partum have been reported by researchers in the Archives of Breast Cancer 2015;2: 4.
literature.4 [8.] Chenng H, Parker EU, Kilgore MR, Sacheal JR,
Radiologic and Pathologic Correlation for Lactating
Furthermore, lactating adenoma should be Adenoma Journal of Breast imaging 2021;3(2):208-
distinguished from carcinomas and other benign tumours 214..
like fibroadenoma under histopathologic examination.1,2,4 [9.] Barco Nobreda I, Vida MC, Fraile M et al. Lactating
Even though our patient Mr AC, presented at 27 weeks Adenoma of the breast. J Hum Lact 2016;32(3):559-
gestation surgery was deferred to 8 weeks post-partum due 569
to her decline of surgery and was treated with oral [10.] Toon JH,Kim EK, Kim MJ et al. Clinical features and
bromocriptin prior to surgery. Literature had shown that Ultra Sonographic findings of Lactating adenoma.
cases of lactating adenoma had surgical excision during Ultrasonography 2009; 28: 11-16.
pregnancy second and third trimesters of pregnancy. 1,2
However, scholars have also reported surgical interventions
of lactating adenoma post-partum as in our index patient for
safety of the pregnant uterus.2,3
Our patient had a breast radiogram prior to surgery at

27 weeks gestation which revealed a huge heterogenous
solid/ cystic hypoechoic left breast mass measuring 9.6 x
8.5cm spanning from 3to 9 o’clock in the lower quadrants.
Skin and soft tissues were engorged and thickened.
However, in the post partum some authors have reported the
use of MRI as a diagnostic tool.1
IV. CONCLUSION
Excision of lactating adenoma post – partum is a safe

surgical procedure and a feasible option of management of
this breast pathology.
REFERENCES
[1.] Magno S, Terribile D, Frances chini G et al. Early

onset lactating adenoma and the role of breast MRI.
A case report J med Case Reports 2009;3:43.
[2.] Teng CY, Diego EJ. Case report of a large lactating
adenoma with rapid antepartum enlargement.
International Journal of Surgery Case Reports
2016;20:127-129.
[3.] Lee JH et al. Useful production mammoplastic
Technique in Oncoplastic Breast Surgery and
Reconstruction.
Https://www.hindani.com>tb(accesssed (1/2/2022).
[4.] Chatterjee A et al. Oncoplastic Surgery: Keeping it
simple with 5 essential Volume Displacement
Technique for Breast Conservation in a patient with
moderate - to – large sized Breast.
Https://journals.siegepub.com>doi(accessed
(1/2/2023)
[5.] Losken A et al. The Oncoplastic Reduction Approach
to Breast Conservation Therapy. Benefits for
management control. Aesthetic Surgery Journal
2014;34(8): 1185-1191.

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Volume 8, Issue 2, February – 2023 International Journal of Innovative Science and Research Technology

Lactating Adenoma: A Case Report

Correspondence: Dr Eli S MBBS, FWACS

Abstract: II. CASE PRESENTATION

IJISRT23FEB074 www.ijisrt.com 2254

Fig. 1: Lactating Adenoma Prior To Surgery

Fig. 2: Lactating Adenoma Post-Surgery

IJISRT23FEB074 www.ijisrt.com 2255

Our patient had a breast radiogram prior to surgery at

Excision of lactating adenoma post – partum is a safe

[1.] Magno S, Terribile D, Frances chini G et al. Early

IJISRT23FEB074 www.ijisrt.com 2256

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