To the Editor.—
The medical therapy advocated by gynecologist Altchek for the 15-year-old girl with a unilateral axillary breast is a brilliant synopsis of the present-day thoughts on "breast swelling" and the factors involved in fibrocystic disease of the breast. However, this child, who is obviously uncomfortable and upset because of a unilateral mass in the axilla, should not begin a multiplicity of semiproved therapies that last until menopause, including many with severe and possible long-term systemic effects. It is amazing to note six paragraphs, including one on diet restriction, full of current hypothetical modalities that have little reference to the present axillary breast tissue problem and but one brief sentence stating that "rarely, surgical excision is considered if the axillary mammary tissue is large or physically or emotionally disturbing." There is a simple procedure performed by plastic surgeons with few, if any, complications that can be applied to enlarged
Freeman BS, Wiemer DR. Axillary Extra Mammary Tissue. JAMA. 1982;248(18):2241. doi:10.1001/jama.1982.03330180015020
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