Dear Beth, Lawrence in her 1994 edition of BREASTFEEDING: A GUIDE..., on page 42, probably suggests the same that you have in the 1989 edition: "...swelling and secretion... may produce pain during lactation.", "...can cause discomfort and embarrassment...", "In rare cases, it may be appropriate to surgically remove the tissue...", "If treatment (referring back to the surgery) is not initiated before pregnancy and lactation ... pain and swelling will be intensified and may progress to mastitis or the necessity to terminate lactation.". Additionally, she reviews findings by Alder et al (Accessory breast tissue in the axilla: mammographic appearance, RADIOLOGY 163: 709, 1987.) of 13 women who were diagnosed on routine mammography. Seven had a mass or fullness on examination, ONE was seen postpartally for pain, and NINE were asymptomatic. Also, Susan Love in her book, DR. SUSAN LOVE'S BREAST BOOK, 1990, page 51-2, suggests that this accessory tissue is often unnoticed by both doctor and patient, and although subject to all the problems of normally situated tissue, her experience with one patient with this unusual circumstance was that the swelling went away upon weaning from the breast (doesn't say when this weaning happened). She suggests to do nothing unless the tissue causes extreme discomfort or psychological distress. I have only seen two women in my limited experience since getting into this field in 1980 with accessory mammary tissue: one mother had an extra nipple only (no problem), and one mother had a nipple and supporting glandular tissue ( swelling, leaking, with eventual involution from disuse). IMHO, I think that the woman should plan to breastfeed, be informed of comfort techniques for swelling and pain - maybe cabbage leaves would help here - pack your phone number with her labor/delivery supplies baggage, and take postpartum one day at a time, like we all do. The Alder research gives one reason to believe that she may have no other symptoms, or her symptoms may diminish with breastfeeding duration, or her symptoms may be tolerable until she decides to wean, at the very least she can enjoy a day or two of breastfeeding and her baby has the advantage of the skin-to-skin contact (something we forget to encourage in the non-breastfeeding mother) and colostrum. Unless her physician has a specific reason that initiating lactation may be HARMFUL to her - maybe something else unrelated to the accessory tissue that was not communicated well to the mother - then I see no reason not to encourage her to give it a shot. Two cents from the peanut gallery, Jeanine Klaus, MS, IBCLC Oakville, Ontario