Illustrated Encyclopedia of Human Anatomic Variation: Opus IV: Organ Systems: Female Genital System

Mammary Gland

Ronald A. Bergman, PhD
Adel K. Afifi, MD, MS
Ryosuke Miyauchi, MD
Peer Review Status: Internally Peer Reviewed

The mammae frequently develop asymmetrically, the right often being larger and lower than the left. While absence of one or both mammae is very rare, with or without associated absence of the nipple, an increase in their number is relatively common occurrence. The supernumerary mammae vary in the extent to which they are developed, being represented sometimes by well-formed accessory glands (polymastia) that may become functioning organs, but more often, particularly in the male subject. Only by rudimentary nipples (polythelia) or even pigmented areas suggesting areolae. In women, polythelia may be associated with greater or less development of glandular tissue.

Doubled nipples have been reported frequently. Hyperthelia is much more common than hypermastia.

The recorded frequency of polythelia in men (14%) is very questionable. A better estimate in healthy individuals is about 4-5% with no sex differences reported. The occurrence of rudimentary supernumerary nipples is undoubtedly more common than usually recognized. Renal variations accompanied polythelia in nine of 37 (27%) subjects studied.

The usual position of the accessory mammae is below and somewhat medial to the usual glands and corresponds to the mammary line in other animals. In some cases, they may be found above and laterally, in the axillary region, especially in Japanese subjects.

The number of accessory or supernumerary glands varies: three pairs in one case, five milk-secreting organs in another, and eight glands in both sexes (1-2% of females and males) have been recorded. They are often asymmetrically placed and not uniformly developed. Comparative studies of the mammae in "lower animals" and the disposition of the supernumerary organs in the human subject suggest the probability that remote human ancestors normally possessed more than two glands; the occasional occurrence of the variant mammae in positions anticipated by the milk-ridges, rudimentary organs sometimes occupy very unusual locations, including the back, lateral thorax, neck, shoulder, inner aspect of the arm, axilla, buttocks, hip, thigh and labium majus.

Massive hypertrophy has been reported, with a combined weight of 124 lbs, with one gland weighing 63 lbs in a 13-year-old girl whose remaing weight was less than the combined weight of the two glands. Excessively large breasts may lead to hyperesthesia in the ulnar nerve distribution in hands (a variant of thoracic outlet syndrome). Micromastia has also been reported.

Variations in Size, Number, Location and Structure of the Mammary Gland in Men and Women

Supernumerary Mammae and Nipples in Men and Women

Supernumerary Mammary Glands

Supernumerary Glands

Mammary Glands, Supernumerary

Supernumerary Nipples

Image 53

Image 68

Quadruple Mammae in a Man

Amastia and Polymastia

Two Nipples

Unilateral absence of a mammary gland in sisters

Four Nipples

References

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