Amazia is a condition in which the mammary gland is missing, but the nipple and surrounding aureola are present. Most commonly, amazia is iatrogenic in nature, meaning that it was caused by a physician, although it is possible for the condition to be congenital. The most common reason for amazia is surgery to remove the mammary gland performed as part of a cancer treatment program, with the goal of excising all cancerous tissue so that it cannot metastasize to neighboring organs.
A closely related condition is amastia. In amastia, the entire breast, including the mammary gland, nipple, and aureola, is absent. People sometimes mistakenly use the term “amastia” to refer to amazia, although the two conditions are different in nature. There are several treatment options available for both, for patients who want treatment.
Once the mammary gland is absent, it will not be possible to produce milk, and treatment for amazia or amastia is usually performed for cosmetic reasons, as some women feel uncomfortable without one or both breasts. The treatment involves the insertion of a breast implant to fill out the tissue, and the nipple may be relocated at the same time, as the implant can change the position of the nipple, causing the breast to appear strange. Patients who do go on to have children may be able to breastfeed from an intact breast if only one was removed, or they will need to bottlefeed; for mothers who want to use breastmilk to feed their infants, it can sometimes be available through a milk bank.
In women who have a breast or both breasts removed during breast cancer treatment, a surgery known as a mastectomy, sometimes reconstruction can be done during the surgery, although some surgeons prefer to wait. In young women who do not develop breasts, a doctor may offer a breast implant as an option after it becomes evident that the patient has gone through puberty and any additional growth is unlikely.
There is another reason for iatrogenic amazia; trans gendered men may opt to have surgery to remove their breasts so that they can bring their bodies into alignment with their gender identity. In this particular instance, no treatment is desired for the missing mammary gland, because the patient specifically opted for removal. During the surgery, the nipple and aureola are relocated so that they will sit in the right position on the man's chest once he recovers.