Reviewer’s report
Title: 
Surgery for Fibroadenoma Arising from Axillary Accessory Breast
Version: 
0 
Date: 
13 Sep 2020
Reviewer: 
Luc Strobbe
Reviewer's report:
Review
Surgery for Fibroadenoma Arising from Axillary Accessory Breast
However mundane this subject may seem to some, AAB can be an annoying
possession. The authors reflect on this problem in a large series. The relation to
fibroadenoma in this AAB and the correlation with fibroadenoma in the
associated breast, make this report unique. However, one can question the
relevance of the fact fibroadenoma's are found in the AAB or the normal breasts.
The authors should not encourage systematic diagnostics in search for
fibroadenoma elsewhere in asymptomatic breasts. Fibroadenoma's pose no
health risk to the woman and should not be sought for. The recommendation to
examine the breasts for residual fibroadenoma has no place in the conclusion in
the abstract. 
The authors report on an amazing number of axillary accessory breasts. In a large
breast centre in Europe, the incidence of symptomatic AAB is insignificantly
low: only once a year we are confronted with this problem. Does there exist
geographical variation in the incidence? Could this have something to do with
the very low BMI the authors describe in their population? Please comment.
What do the authors mean by the following: p7, line 47 "The onset of AAB
symptoms was more frequent after puberty in the fibroadenoma group (79.5%)
than in the non-fibroadenoma group (57.0%)"?
Please clarify in the text
Nowhere in the article the presence of accessory nipple in AAB is mentioned.
The reader can wonder how often AAB is accompanied with an accessory nipple
and possibly more nipples in the nipple line, which can extend onto the
abdomen.
The supposed need to search for fibroadenoma in the breast should be
questioned. It can be mentioned in the discussion as a possibility. In that case,
however, this superfluous diagnostic should be substantiated with arguments.
P12 line 1: "and require ultrasonography of the entire breast prior to AAB
excision"
This way of acting of the authors should not be part of the conclusions. There is
no ground to recommend removing asymptomatic fibroadenoma. 
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