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Anatomy Atlases: Illustrated Encyclopedia of Human Anatomic Variation: Opus IV: Organ Systems: Mammary Gland

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.

Image 47 Variations in Size, Number, Location and Structure of the Mammary Gland in Men and Women

Image 48 Supernumerary Mammae and Nipples in Men and Women

Image 49 Supernumerary Mammary Glands

Image 50 Supernumerary Glands

Image 51 Mammary Glands, Supernumerary

Image 52 Supernumerary Nipples

Image 53 Image 53

Image 68 Image 68

Image 69 Quadruple Mammae in a Man

Image 70 Amastia and Polymastia

Image 101 Two Nipples

Image 103 Unilateral absence of a mammary gland in sisters

Image 106 Four Nipples


Albert, H. (1910) Diffuse idiopathic hypertrophy of the mammary glands of the female. JAMA 55:1339-1343.

Banner, E.R. (1946) Unilateral micromastia associated with abnormalities of musculature of chest wall on same side. Brit. Med. J. 2:420.

Bartels, M. (1872) überzahl der Brustwarzen. Arch. Anat. Physiol. Wissen. Med. 1872:304-306.

Bartles, M. (1875) Ueberzahl der Brustwarzen. Archir f. Anat. Physiol. u. Wissenschafliche Medicin. 1875:746-751.

Batchelor, H.T. (1888) Absence of mammae in a woman. Brit. Med. 2:876.

Blanchard, R. (1885) Sur un case de polymastie et sur la signification des mamelles surnuméraires. Bull. de la Soc. d'Anthrop. de Paris. 8:226-239.

Blanchard, R. (1886) Sur un case remarquable de polythélie héréditaire. Bull. de la Soc. d'Anthrop. de Paris. 9:485-487.

Bloch, A. (1909) Presentation de portraits de juenes négresses pour faire voir la forme particuliére de l''auréole de la mamelle. Bull. et Mém. de la Soc. d'Anthrop. de Paris. 10:141-142.

Blum, -. (1907) Fall von supernumerärer Mamma im Berich des behaarten Mons veneris mit 7 Warzen. Münchener Med Wochenschr. 54:1055.

Bok, E.J. (1926) über das Vorkommen uberzahliger Brustwarzen bei Javanen. Anat. Anz. 61:292- 297.

Braquehaye, J. and -. Remlinger. (1899) Mamelle surnuméraire audessous de l'ombilic chez un homme. Soc. Biol. Comptes Rendus Hedomadaires des Séances et Mémoires. 51:598-599.

Brightmore, T. (1972) Bilateral double nipples. Brit. J. Surg. 59:55-57.

Bruce, J.M. (1879) Supernumerary nipples and mammae. With an account of sixty-five instances observed. J. Anat. Physiol. 13:425-448.

Champneys, F.H. (1886) On the development of mammary functions by the skin of lying-in women. Medico-chirurgical Trans. 69:419-442.

Champneys, F.H. and A.A. Bow1by (1895) Further observations on the development of mammary functions by the skin of lying-in women. Medico-chirurgical Trans 78:267-273.

Charcot, -. et -. LeGendre. (1859) Deux cas mamelons surnuméraires obsérves chez la femme. Soc. Biol. Comptes Rendus des Séances et Mémoires 11:164-165.

De Cholnoky, T. (1939) Supernumerary breast. Arch. Surg. 39:926-941.

Coe, A.H. (1888) Case of supernumerary nipple associated with maternal impression. Med. Rec. 34:479.

Deslongchamps, -. and -. Rayner. (1852) Mamelles surnuméraires chez la femme. Soc. Biol. Comptes Rendus des Séances et Mémoires. 4:9-10.

Domansky, K.Z. (1947) Hyperthelie-hypermastie. Rozheldy v. Chirurgii 26:88-91. Cited in Exerpta Medica, Sec. 1, Vol. 3, anbstract 384, 1949.

Dunn, C.W. (1944) Gynecomastia. Delaware State Med. 116:63-69.

Evans, W. (1959) Polythelia in cardio-arterial disease. Brit. Heart J. 21:130-136.

Foster, A. (1916-17) Ein Fall überzähliger rudimentärer Mammabildung an der Innenseite des Oberschenkels eines Mannes. Anat. Anz. 49:529-535.

Fraser, F.C. (1956) Dominant inheritance of absent nipples and breasts. In Novant'anni delle leggi mendeliane, pp. 360-362. Instituto Gregorio Mendel, Rome.

Glos, J. (193 2) Amazia bilaterialis se soucasnou malformacikoncetin. Casop. Lék. Cesk. 71:865.

Goldberger, H. (1895) Ein seltene Fall von Polymastie Arch. f. Gynaekologie 49:272-277.

Goldenring, H. and E.S. Crelin. (196 1) Mother and daughter with bilateral amastia. Yale J. Biol. Med. 33:466-467.

Haenel, H. 91928) Ein fall von dauern der Milchsekretion beim Mann. Münchener Med. Wochenschr. 75:261-263.

Handyside, P.D. (1873) Notice of quadruple mammae, - the two lower rudimentary - in two adult brothers. J. Anat. Physiol. 7:56-59.

Hare, C.J. (1860) On a case of secretion of milk from the right axilla. Lancet 2:405-407.

Iwai, T. (1907) A statistical study of polymastia of the Japanese. Lancet 2:753-759.

Iwanovitch-Stoyanov, P. (1898) Note sur quelques cas de polymastie et de polythélie chez l'homme. Bull. de la Soc. d'Anthrop. de Paris. 9:301-305.

Kahn, S.A. and R.F. Wagner, Jr. (1982) Polythelia and unilateral renal agenesis. Cutis 30:225-226.

Karsner, H.T. (1946) Gynecomastia. Am. J. Pathol. 22:235-315.

Klinkerfuss, G.H. (1924) Four generations of polymastia. JAMA 82:1247-1248.

Kowlesser, M. and E. Orti. (1968) Complete breast absence in siblings. Am. J. Dis. Child. 115:91-92.

Landau, T. (1890) über einige Anomalien der Brustdrüsensecretion. Dtsch. Med. Wochenschr. 16:745-747.

Latarjet, A. (1931) Testut's Traite d'Anatomie Humain, Tome V, G. Doin & Cie, Paris.

LeDouble, A. (1875) Hypertrophie de deux mamelles chez une fille de 15 ans. Bulletins et Mem. de la Société Anatomique de Paris L(3):185-189.

Leichtenstern, -. (1878) über das Vorkommen und die Bedeutung supernumerärer (accessorischer) Brüste und Brustwarzen. Auf Grund 13 eigener und 19 aus der Literatur gesammelter Beobachtungen. Arch. Pathol. Anat. Physiol. Klin. Med. 73:222-256.

Iwai, T. (1907) A statistical syudy on the polymastia of the Japanese. The Lancet (Sept. 14.) 753-759.

Louria, H.W. (1924) Case of unilateral amastia. Am. J. Obstet. Gynecol. 8:364-365.

Manec, -. (1859) Hypertrophie mammaire énorme chez une jeune fils de dix-sept ans. Gaz. des Hôp. 32(12):45-46.

Marjolin, -. (1868) Hypertrophie diffuse de la glande mamaire. Amputation du sein. Gaz des Hôp. 41:519.

Marie, M.P. (1893) Mamelon surnuméraire transmis héréditairement dans une famille; coincience avec plusiers grosses gémeflaires; reversion atavique à - ou creation d'un-type polymastie et polygéne. Bull. et Mém. Soc. Med. de Hôp. de Paris. 10:457-459.

Martin, E. (1893) Beitrage zur Lehre von der Polymastie und ihrer Beziehung zur Entwickelung von Brustdrüsengeschwülsten. Arch. f Klin. Chirurgie (Langenbecks) 45:880-891.

McGillicuddy, T.J. (1891) The mammae and their anomalies. Med. Rec. 40:446-448.

Méhes, K. (1979) Association of supernumerary nipples with other anomalies. J. Pediatr. 95:274-275.

Méhes, K. (1983) Association of supernumerary nipples with other anomalies. J. Pediatr. 102:161.

Monod, -. (1881) Hypertrophie mammaire. Gaz. de Hôp. 54(93):741.

de Mortillet, G. (1883) Homme de six mamelles. Bull. de la Soc. d'Anthrop. de Paris. 6:458-459.

Moullin, J.A.M. (1883) Case of hypertrophy of the breasts. Trans. Obstet. Soc. Lond. 27:212.

Murchison, -. (1866) Supplementary nipples or pleiomazia. Trans. Path. Soc. London. 17:426-428.

Neugebauer, Jr., F.L. (1886) Eine bisher einzig dastehende Beobachtung von Polymastie mit 10 Brustwarzen. Centralblatt f. Gyndkologie 10:729-736.

Neumann, H.O. und M. Oing. (1929) Polymastie und Polythelie. Eine klinische studie mit einem entwicklungsgeschictlichen Histologischen Beitrag. Arch. f. Gynäkol. 138:494-542.

Osbourn, R.A. (1956) Congenital ectodermal defect with amastia. Med. Ann. District of Columbia 25:204-205.

Paravicini, G. (1903) Cas de polymastie, ou de pléomazie, chez des individus de sexe masculin. Arch. Ital. Biol. 40:325.

Paull, F. (1862) Total absence of the left mammary gland from non-development. Lancet 1:648.

Peiper, -. (1891) mangel des linken M. pectoralis major (portio sternocostalis) , des M. pectoralis minor, der linken brustwarze eines Theiles des M. serratus anticus major, und des M. latissmus dorsi. Deutsche Med. Wochenschr. 17(7):265.

Pellegrini, J.R. and R.F. Wagner, Jr. (1983) Polythelia and associated conditions. Am. Fam. Physician 28:129-132.

Perkins, R.A. (1921) Supernumerary breast on buttock. JAMA 76:792.

Petrone, A. (1889) Contribuzione alla teoria dell'atavismo in um caso raro di polimastia maschile (6 mammelle). Progresso Med. (Napoli) 3:516-524.

Pieraccini, G. (1934) Asimmetria morfologica, differenze anatomica e fisiologica tra le mammelle nella donna. Arch. Ital. Anat. Embriol. 33:71-94.

Petrignani, R. (1939) Polymastie et gémellité. Bull. Soc. Gynec. et d'Obstet. 28:306-307.

Purves, R. and J.A. Hadley. (1927) Accessory breasts in the labia majora. Brit. J. Surg. 15:279-281.

Romanus, T. (1948) A pedigree showing the incidence of malformation of the nipples. Acta Genetic. Statist. Med. 1:168-173.

Schilssler, F. (1892) Ueber Hypertrophie der weiblichen Brustdiise. Arch. f. Gynaekologie 43:403- 428.

Schneller, E.W. (1898) Congenital amazia. Med. Rec. 53:282.

Shewmake, S.W. and G.T. Izuno. (1977) Supernumery areolae. Arch. Dermatol. 113:823-825.

Simard, R. (1948) Sur un cas d'amastie. Laval Med. 13:687-690.

Simpson, G. (1913) A case of amastia. Brit. J. Surg. 1:336-337.

Smith, S.F. (1880) Axilla Lactation. Louisville Medical News 10:231-232.

Speert, H. (1942) Supernumerary mammae, with special reference to the Rhesus monkey. The Quart. Rev. Biol. 17:59-68.

Sutton, J.B. (1889) Supernumerary mammae and nipples in man, monkeys, cows, etc. Am. J. Med. Sci. 97:247-257.

Tawil, H.M. and S.S. Najjar. (1968) Congenital absence of the breasts. J. Pediatrics. 73:751-753.

Testut, L. (1883) Note sur un cas de mamelle surnuméraire observée chez la femme. Bull. Soc. d'Anthropol. de Paris S.3. 6:649-651.

Testut, L. (1883) Note sur un cas de mammelle crurale observé chez la femme. Bull. de la Soc. d'Anthrop. de Paris. 2:757-759.

Trier, W.C. (1965) Complete breast absence. Case report and review of the literature. Plast. Reconstructive Surg. 36:430-436.

Varsano, I.B., Jaber, L., Garty, B., Mukamel, M.M. and M. Grünebaum. (1984) Urinary tract abnormalities in children with supernumerary nipples. Pediatrics 73:103-105.

Vassal, P.A. et P. Voizard. (1955) L'hyperthélie en Afrique du Nord. Assoc. Anatomistes Comptes Rendus 42:1371-1380.

Verneuil, -. (1854) Hypertrophie mammaire. Bulletins et Mem. de la Société Anatomique de Paris XXIX(4):1-2.

Weinberg, S.K. and A.G. Molusky. (1976) Aberrant axillary breast tissue. A report of a family with six affected women in two generations. Clin. Genet. 10:325-328.

Weinshel, L.R. and N. Demakopoulos. (1943) Supernumerary breasts: With special reference to the pseudomamma type. Am. J. Surg. 60:76-80.

Whyte, G.D. (1904) Congenital absence of the breast and of the greater pectoral muscle in a man. Lancet 2:1249.

Williams, W.R. (1891) Polymastism, with special reference to mammae erraticae and development of neoplasms from supernumerary mammary structures. J. Anat. Physiol. 25:225-255.

Williams, W.R. (1891) Mammary variations per defectum. J. Anat. Physiol. 25:304-315.

Wylie, W. (1885) Case of entire absence of both mammae in a female, age 21 years. Brit. Med. J. 1885(2):235.

Zander, R. (1903) Ein Fall von echtem Hermaphroditismus beim Menschen. Anat. Anz. 23:27-28.

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