Breast hypertrophy

Last updated
Breast hypertrophy
Hypertrophy of breast 10.png
Specialty Gynecology, endocrinology
Symptoms Excessively large breast tissue
Risk factors Increased levels or heightened sensitivity to certain hormones and/or growth factors

Breast hypertrophy is a rare medical condition of the breast connective tissues in which the breasts become excessively large. The condition is often divided based on the severity into two types, macromastia and gigantomastia. Hypertrophy of the breast tissues may be caused by increased histologic sensitivity to certain hormones such as female sex hormones, prolactin, and growth factors. [1] Breast hypertrophy is a benign progressive enlargement, which can occur in both breasts (bilateral) or only in one breast (unilateral). It was first scientifically described in 1648. [2]

Contents

Description and types

The indication is an excess breast weight that exceeds approximately 3% of the total body weight. [3] There are varying definitions of what is considered to be excessive breast tissue, that is the expected breast tissue plus extraordinary breast tissue, ranging from as little as 0.6 kilograms (1.3 lb) up to 2.5 kilograms (5.5 lb) with most physicians defining macromastia as excessive tissue of over 1.5 kilograms (3.3 lb). Some resources distinguish between macromastia (Greek, macro: large, mastos: breast), where excessive tissue is less than 2.5 kg, and gigantomastia (Greek, gigantikos: giant), where excessive tissue is more than 2.5 kg. [4] [5] The enlargement can cause muscular discomfort and over-stretching of the skin envelope, which can lead in some cases to ulceration. [6]

Hypertrophy of the breast can affect the breasts equally, but usually affects one breast more than the other, thereby causing asymmetry, when one breast is larger than the other. The condition can also individually affect the nipples and areola instead of or in addition to the entire breast. The effect can produce a minor size variation to an extremely large breast asymmetry. Breast hypertrophy is classified in one of five ways: as either pubertal (virginal hypertrophy), gestational (gravid macromastia), in adult women without any obvious cause, associated with penicillamine therapy, and associated with extreme obesity. [6] Many definitions of macromastia and gigantomastia are based on the term of "excessive breast tissue", and are therefore somewhat arbitrary.

A total of 115 cases of gigantomastia had been reported in the literature as of 2008. [7]

Virginal breast hypertrophy

When gigantomastia occurs in pubescent females, the medical condition is known as juvenile macromastia or juvenile gigantomastia and sometimes as virginal breast hypertrophy or virginal mammary hypertrophy. Along with the excessive breast size, other symptoms include red, itchy lesions and pain in the breasts. A diagnosis is made when an adolescent's breasts grow rapidly and achieve great weight, usually soon after their first menstrual period. Some doctors suggest that the rapid breast development occurs before the onset of menstruation. [8]

Some adolescents with virginal breast hypertrophy experience breast growth at a steady rate for several years, after which the breasts rapidly develop exceeding normal growth. Some adolescent females experience minimal or negligible breast growth until their breasts suddenly grow very rapidly in a short period of time. This may cause considerable physical discomfort. Individuals with VBH often experience an excessive growth of their nipples as well. In severe cases of VBH, clitoromegaly occurs.[ citation needed ]

At the onset of puberty, some females who have experienced little or no breast development can reportedly reach three or more cup sizes within a few days (see below). [9]

As of 1992, 70 cases of virginal breast hypertrophy had been reported. [10]

Gestational breast hypertrophy

This same effect can also occur at the onset of pregnancy or between the 16th to 20th week of gestation. When the swelling in the connective tissue occurs after birth, it can negatively impact long term milk supply. [9] The swelling increases with each subsequent pregnancy.

The extremely rapid growth of the breasts can result in intense heat. The woman's breasts can generate extraordinary discomfort, turning feverish, red, itchy, and even causing the skin to peel. The swelling can suppress the milk supply, pinching off the milk ducts, and leading to mastitis. [9]

Gestational gigantomastia is estimated to occur in 1 out of every 28,000 to 100,000 pregnancies. [11] [12]

Breast size in women with gestational breast hypertrophy typically reverts to approximately pre-pregnancy size or near it after pregnancy and cessation of breastfeeding. [13] [14] [15] This is not always the case however and in some only partial reduction in breast size may occur, necessitating surgical breast reduction. [16] [17]

Other types of breast hypertrophy

Only 15% of cases of breast hypertrophy are unrelated to puberty or pregnancy. [18] Other types and causes of breast hypertrophy include idiopathic, drug-induced (e.g., penicillamine, ciclosporin, bucillamine), autoimmunity-associated, tumors, and syndromes. [18] Two case reports of prepubertal breast hypertrophy, both in infants, have been reported. [19] [20] [21]

Causes

The underlying cause of the rapidly growing breast connective tissue, resulting in gigantic proportions, has not been well elucidated. However, proposed factors have included increased levels/expression of or heightened sensitivity to certain hormones (e.g., estrogen, progesterone, and prolactin) [22] and/or growth factors (e.g., hepatocyte growth factor, insulin-like growth factor 1, and epidermal growth factor) in the breasts. [23] [24] Macromastic breasts are reported to be composed mainly of adipose and fibrous tissue, while glandular tissue remains essentially stable. [25]

Macromastia occurs in approximately half of women with aromatase excess syndrome (a condition of hyperestrogenism). [26] [27] Hyperprolactinaemia has been reported as a cause of some cases of macromastia. [28] [29] Macromastia has also been associated with hypercalcaemia (which is thought to be due to excessive production of parathyroid hormone-related protein) and, rarely, systemic lupus erythematosus [25] and pseudoangiomatous stromal hyperplasia. [30] It is also notable that approximately two-thirds of women with macromastia are obese. [25] Aside from aromatase (as in aromatase excess syndrome), at least two other genetic mutations (one in PTEN) have been implicated in causing macromastia. [31] [32]

A handful of drugs have been associated with gigantomastia, including penicillamine, bucillamine, neothetazone, ciclosporin, indinavir, and prednisolone. [25] [33] [34]

Treatment

Medical treatment has not proven consistently effective. Medical regimens have included tamoxifen, [35] progesterone, bromocriptine, the gonadotropin-releasing hormone agonist leuprorelin, and testosterone. Gestational macromastia has been treated with breast reduction drugs alone without surgery. [36] Surgical therapy includes reduction mammaplasty and mastectomy. [37] However, breast reduction is not clinically indicated unless at least 1.8 kilograms (4.0 lb) of tissue per breast needs to be removed. [38] In the majority of cases of macromastia, surgery is medically unnecessary, depending on body height. Topical treatment includes regimens of ice to cool the breasts. [9]

Treatment of hyperprolactinemia-associated macromastia with D2 receptor agonists such as bromocriptine and cabergoline has been found to be effective in some, but not all cases. [39] [40] Danazol, an antiestrogen and weak androgen, has also been found to be effective in the treatment of macromastia. [41]

When hypertrophy occurs in adolescence, noninvasive treatments, including pharmaceutical treatment, hormone therapy, and steroid use are not usually recommended due to known and unknown side effects. Once breast growth rate has stabilized, breast reduction may be an appropriate choice. In some instances after aggressive or surgical treatment, the breast may continue to grow or re-grow, a complete mastectomy may be recommended as a last resort.

Pregnancy is recognized as the second most common reason for hypertrophy. When secondary to pregnancy, it may resolve itself without treatment after the pregnancy ends. [13]

Society and culture

Difficulties

Extremely large breasts are a source of considerable attention. [42] [43] [44] [45] Some women try to hide or mask their breasts with special clothing, including minimizing bras. Women with this condition may be subject to psychological problems due to unwanted attention or harassment. Depression is common in those affected.

In the case of a 12-year-old Japanese girl reported in 1993, her "massively enlarged" breasts caused her "intense psychological problems, incapacitating her in school activities and social relations". [46] Actress Soleil Moon Frye, who starred as a child in the sitcom Punky Brewster , reported in an interview with People magazine that boys taunted her, calling her "Punky Boobster". It affected her professional and social life negatively. "People started to think of me as a bimbo," she said in the interview. "I couldn't sit up straight without people looking at me like I was a prostitute[.]" She had breast reduction surgery at the age of 15. [47]

Finding large bra-sizes and styles that fit is challenging. Also, larger bras are more costly, challenging to find, and unflattering to the wearer. Ill-fitting bras with narrow straps can cause chronic irritation, redness, and indentations in the shoulders. Skin rashes under the breasts are common, particularly during warm weather. Heavy breasts may cause headaches, neck pain, upper and lower back pain, and numbness or tingling in the fingers. There is a possible connection between macromastia and carpal-tunnel-syndrome. [48] [ better source needed ]

Medical insurance coverage

Insurance companies in the United States typically require the physician to provide evidence that a woman's large breasts cause headaches or back and neck pain before they will pay for breast reduction. Insurance companies also mandate a woman who is overweight, which is often the case with gigantomastia, to first lose a certain amount of weight. They also commonly require the patient to try alternative treatments like physical therapy for a year or more. [49]

Reported instances

Gigantomastia

The first recorded case of gigantomastia, diagnosed in a 23- or 24-year-old woman, 1669. In 1669, the physician William Durston drew this illustration of first recorded case of non-gravid gigantomastia; the woman died of the condition. Durston gigantomastia 1670.png
The first recorded case of gigantomastia, diagnosed in a 23- or 24-year-old woman, 1669. In 1669, the physician William Durston drew this illustration of first recorded case of non-gravid gigantomastia; the woman died of the condition.

The earliest description and illustration of gigantomastia dates to 1669. [50] In July of that year the Plymouth physician William Durston wrote to the Royal Society, reporting the case of a patient named Elizabeth Travers (sometimes spelled Treves). Durston's account was soon published in the Society's Philosophical Transactions, and includes the following account of the onset of symptoms:

Elizabeth Treves, 23. or 24. years of age, fair of complexion, brown-hair’d, of an healthy constitution, low of stature, of honest repute, but of mean and poor parentage, near this Town [Plymouth], was on Friday July 3d, 1669 in good health, and went well to bed, where she took as good rest and sleep, as ever before, but in the morning, when she awaken’d, and attempted to turn herself in her bed, was not able, finding her Breasts so swell’d, that she was affrighted to an astonishment. Then endeavoring to sit up, the weight of her Breasts fastned her to her bed; where she hath layn ever since, yet without all pain and weakness either in her Breasts, or in any other part. [51]

Durston later wrote to the Society to report that Travers had died on October 21 of the same year, four months after the onset of enlargement. One breast removed after the woman's death weighed 29 kg (64 lb). [52] Durston did not, as is sometimes stated, carry out breast reduction or mastectomy, instead favouring a range of medicines, the details of which are redacted in the published account in the Philosophical Transactions. [51]

A painting by Lam Qua of Lu-shi, age 42, on April 17, 1848, prior to breast reduction surgery. 1848 lam aua hypertrophy.jpg
A painting by Lam Qua of Lu-shi, age 42, on April 17, 1848, prior to breast reduction surgery.

On April 17, 1848, a 42-year-old woman named Lu-shi was treated for hypertrophy in a Chinese hospital. She was treated by a missionary physician. On December 24, 1849, the left breast, measuring 67 cm (26 in) in circumference, and weighing 2.7 kg (6.0 lb), was removed in a procedure lasting three and a half minutes. The right breast was removed one month later. It measured 61 cm (24 in) in circumference and weighed 2.5 kg (5.5 lb). [53]

In 2005, a woman reported that her breasts grew at puberty from nothing to a C cup in one month. When she became pregnant for the first time, her breasts increased two cup sizes in a few days. Immediately after her first birth, her breasts grew three cup sizes. After her second child was born, her breasts increased six cup sizes. After her third childbirth, they grew 10 cup sizes, and after her fourth child was born, they grew nine cup sizes. In this instance, the swelling abated about 10 days after childbirth, but her bra cup size remained E to a G for the next year. About one year postpartum, her breasts rapidly atrophied to AA cup size. [9]

One of the most severe cases of macromastia was reported from Ilorin in Nigeria. In 2007, Ganiyu Adebisi Rahman and his colleagues reported the case of a 26-year-old woman who presented with massive swelling of her breasts and bilateral axillary swellings of 6 years duration. Rahman led a team of surgeons in Ilorin to perform a total bilateral excision of the hypertrophied axillary breasts, and bilateral breast amputation with composite nipple-areola complex graft of the normally located breasts. The total weight of the breast tissues removed was 44.8 kilograms (99 lb). [54]

Another extreme case was observed in 2008 in Maria Vittoria Hospital in Turin, Italy, where the amount removed from both breasts was 17.2 kg (38 lb). The growth occurred during puberty making it a case of juvenile gigantomastia, but the patient did not seek treatment until the age of 29. [55] Another extreme case was observed on August 28, 2003, when a 24-year-old woman was admitted to the Clinical Center Skopje in North Macedonia with gigantomastia of pregnancy and the amount later removed from both breasts was 15 kg (33 lb) in total. [56] [57] A second case in North Macedonia was reported when the breasts of a 30-year-old woman from a remote mountain village in eastern North Macedonia suddenly grew to more than 30 kilograms (66 lb) total. [57]

As the disorder becomes more widely known, media reports have increased. French Canadian Isabelle Lanthier appeared[ when? ] on Montel Williams' talk show where she told how her chest grew from 86 cm (34 in) to 133 cm (52 in) in five months during her pregnancy. At their largest, one breast weighed 6.8 kg (15 lb) and the other 5.4 kg (12 lb). Her husband custom-made a special bra to support her breasts.[ citation needed ]

In 2007, a Chilean TV station covered the story of 32-year-old Yasna Galleguillos from Antofagasta, who experienced ongoing back pain, making everyday tasks very difficult to perform. She underwent breast reduction surgery to relieve her pain. Surgeons removed 4.25 kilograms (9.4 lb) from one breast and 3.33 kilograms (7.3 lb) from the other breast. [58]

On October 29, 2009, the Philippine television network GMA News and Public Affairs, producers of Wish Ko Lang ("Just My Wish") hosted by Vicky Morales, profiled the story of Pilma Cabrijas, a 30-year-old woman affected by gigantomastia. The woman was told by a folk healer that her condition may have been caused by a curse. The measured bust circumference without appropriate bra support was 160 cm (63 in). The weight of her breasts was not reported in detail, but seemed to weigh "as much as two children." She had breast reduction surgery performed, but her breasts regrew. The producers of Wish Ko Lang paid for additional surgery. [59]

Virginal breast hypertrophy

In 1993, the Japanese journal Surgery Today reported on the case of a 12-year-old girl. Only 152 centimetres (60 in) tall and weighing 43 kilograms (95 lb), her breasts began to develop at age 11 before the onset of menstruation. Over the next eight months, both breasts grew abnormally large, and physicians treating her found that her physiological development was normal except for her breasts. The weight produced by their symmetrical and massive enlargement resulted in marked curvature of the spine. Lab tests of her blood for hormones and biochemical substances showed normal values, though tests revealed that it might have been caused by hypersensitivity to estrogen. She underwent a bilateral reduction mammoplasty. Surgeons removed 2 kilograms (4.4 lb) of tissue from her right breast and 1.9 kilograms (4.2 lb) from her left breast. She was administered tamoxifen afterward to suppress breast regrowth. [46]

A more severe case of virginal breast hypertrophy of an 11-year-old girl was reported in 2008. The breasts had begun to grow rapidly at puberty and had reached the point of causing physical impairment and respiratory compromise after one year. The skin was intact without any ulcerations. Blood chemistry and endocrine investigation was normal. A bilateral reduction mammaplasty with free nipple grafts was performed. 6 kg (13 lb) of the right breast and 6.5 kg (14 lb) of the left breast were removed, resulting in a removal of 12.5 kg (28 lb) of tissue in all (24% of the total body weight). [60]

See also

Related Research Articles

<span class="mw-page-title-main">Breast</span> Region of the torso of a primate that in females serves as a mammary gland

The breasts are two prominences located on the upper ventral region of the torso among humans and other primates. Both sexes develop breasts from the same embryological tissues. The relative size and development of the breasts is a major secondary sex distinction between females and males. There is also considerable variation in size between individuals. Female humans are the only mammals which permanently develop breasts at puberty; all other mammals develop their mammary tissue during the latter period of pregnancy; at puberty, estrogens, in conjunction with growth hormone, cause permanent breast growth.

<span class="mw-page-title-main">Hyperthyroidism</span> Clinical syndrome caused by excessive thyroid hormone

Hyperthyroidism is the condition that occurs due to excessive production of thyroid hormones by the thyroid gland. Thyrotoxicosis is the condition that occurs due to excessive thyroid hormone of any cause and therefore includes hyperthyroidism. Some, however, use the terms interchangeably. Signs and symptoms vary between people and may include irritability, muscle weakness, sleeping problems, a fast heartbeat, heat intolerance, diarrhea, enlargement of the thyroid, hand tremor, and weight loss. Symptoms are typically less severe in the elderly and during pregnancy. An uncommon but life-threatening complication is thyroid storm in which an event such as an infection results in worsening symptoms such as confusion and a high temperature; this often results in death. The opposite is hypothyroidism, when the thyroid gland does not make enough thyroid hormone.

<span class="mw-page-title-main">Plastic surgery</span> Medical surgical specialty

Plastic surgery is a surgical specialty involving the restoration, reconstruction, or alteration of the human body. It can be divided into two main categories: reconstructive surgery and cosmetic surgery. Reconstructive surgery covers a wide range of specialties, including craniofacial surgery, hand surgery, microsurgery, and the treatment of burns. This category of surgery focuses on restoring a body part or improving its function. In contrast, cosmetic surgery focuses solely on improving the physical appearance of the body. A comprehensive definition of plastic surgery has never been established, because it has no distinct anatomical object and thus overlaps with practically all other surgical specialties. An essential feature of plastic surgery is that it involves the treatment of conditions that require or may require tissue relocation skills.

<span class="mw-page-title-main">Mammaplasty</span> Surgically modifying the appearance of the breast

Mammaplasty refers to a group of surgical procedures, the goal of which is to reshape or otherwise modify the appearance of the breast. There are three main types of mammoplasty:

  1. Augmentation mammaplasty is commonly performed to increase the size, change the shape, and/or alter the texture of the breasts. This usually involves the surgical implantation of breast implants.
  2. Reduction mammaplasty is commonly performed to reduce the size, change the shape, and/or alter the texture of the breasts. This involves the removal of breast tissue.
  3. Reconstructive mammoplasty is breast reconstruction that is done after mastectomy to give the breasts an appearance that is more normal/familiar.
<span class="mw-page-title-main">Cooper's ligaments</span> Connective tissue in the breast that help maintain structural integrity

Cooper's ligaments are connective tissue in the breast that help maintain structural integrity. They are named for Astley Cooper, who first described them in 1840. Their anatomy can be revealed using transmission diffraction tomography.

Gender-affirming surgery for male-to-female transgender women or transfeminine non-binary people describes a variety of surgical procedures that alter the body to provide physical traits more comfortable and affirming to an individual's gender identity and overall functioning.

<span class="mw-page-title-main">Breast augmentation</span> Surgical procedure

Breast augmentation and augmentation mammoplasty is a cosmetic surgery procedure, which uses breast-implants and/ or fat-graft mammoplasty technique to increase the size, change the shape, and alter the texture of the breasts. Although in some cases augmentation mammoplasty is applied to correct congenital defects of the breasts and the chest wall in other cases it is performed purely for cosmetic reasons.

<span class="mw-page-title-main">Breast reduction</span> Plastic surgery procedure

Reduction mammoplasty is the plastic surgery procedure for reducing the size of large breasts. In a breast reduction surgery for re-establishing a functional bust that is proportionate to the patient's body, the critical corrective consideration is the tissue viability of the nipple–areola complex (NAC), to ensure the functional sensitivity and lactational capability of the breasts. The indications for breast reduction surgery are three-fold – physical, aesthetic, and psychological – the restoration of the bust, of the patient's self-image, and of the patient's mental health.

<span class="mw-page-title-main">Fibroadenoma</span> Medical condition

Fibroadenomas are benign breast tumours characterized by an admixture of stromal and epithelial tissue. Breasts are made of lobules and ducts. These are surrounded by glandular, fibrous and fatty tissues. Fibroadenomas develop from the lobules. The glandular tissue and ducts grow over the lobule to form a solid lump.

<span class="mw-page-title-main">Breast implant</span> Prosthesis used to change the size, shape, and contour of a persons breast

A breast implant is a prosthesis used to change the size, shape, and contour of a person's breast. In reconstructive plastic surgery, breast implants can be placed to restore a natural looking breast following a mastectomy, to correct congenital defects and deformities of the chest wall or, cosmetically, to enlarge the appearance of the breast through breast augmentation surgery.

Mastopexy is the plastic surgery mammoplasty procedure for raising sagging breasts upon the chest of the woman, by changing and modifying the size, contour, and elevation of the breasts. In a breast-lift surgery to re-establish an aesthetically proportionate bust for the woman, the critical corrective consideration is the tissue viability of the nipple-areola complex (NAC), to ensure the functional sensitivity of the breasts for lactation and breast-feeding.

<span class="mw-page-title-main">Ptosis (breasts)</span> Sagging of the female breast

Ptosis or sagging of the female breast is a natural consequence of aging. The rate at which a woman's breasts drop and the degree of ptosis depends on many factors. The key factors influencing breast ptosis over a woman's lifetime are cigarette smoking, her number of pregnancies, higher body mass index, larger bra cup size, and significant weight change. Post-menopausal women or people with collagen deficiencies may experience increased ptosis due to a loss of skin elasticity. Many women and medical professionals mistakenly believe that breastfeeding increases sagging. It is also commonly believed that the breast itself offers insufficient support and that wearing a bra prevents sagging, which has not been found to be true.

Theca lutein cyst is a type of bilateral functional ovarian cyst filled with clear, straw-colored fluid. These cysts result from exaggerated physiological stimulation due to elevated levels of beta-human chorionic gonadotropin (beta-hCG) or hypersensitivity to beta-hCG. On ultrasound and MRI, theca lutein cysts appear in multiples on ovaries that are enlarged.

SPAIR is a short-scar breast surgery technique developed by Dennis C. Hammond, assistant professor of surgery at Michigan State University. The technique was designed to allow a better-shaped breast, a limited amount of scarring, and a more accelerated healing process, by eliminating the lateral scar beneath the breast found in conventional breast reduction surgery. The technique is considered to be a good alternative to vertical mammoplasty.

<span class="mw-page-title-main">Maternal physiological changes in pregnancy</span>

Maternal physiological changes in pregnancy are the adaptations that take place during pregnancy that enable the accommodation of the developing embryo and fetus. These are normal physiological adaptations that cause changes in behavior, the functioning of the heart, blood vessels, and blood, metabolism including increases in blood sugar levels, kidney function, posture, and breathing. During pregnancy numerous hormones and proteins are secreted that also have a broad range of effects.

<span class="mw-page-title-main">Gynecomastia</span> Endocrine system disorder of human male breast

Gynecomastia is the non-cancerous enlargement of one or both breasts in men due to the growth of breast tissue as a result of a hormone imbalance between estrogens and androgens. Physically speaking, gynecomastia is completely benign, but it is associated with significant psychological distress, social stigma, and dysphoria.

<span class="mw-page-title-main">Mammoplasia</span> Normal or spontaneous enlargement of breasts

Mammoplasia is the normal or spontaneous enlargement of human breasts. Mammoplasia occurs normally during puberty and pregnancy in women, as well as during certain periods of the menstrual cycle. When it occurs in males, it is called gynecomastia and is considered to be pathological. When it occurs in females and is extremely excessive, it is called macromastia and is similarly considered to be pathological. Mammoplasia may be due to breast engorgement, which is temporary enlargement of the breasts caused by the production and storage of breast milk in association with lactation and/or galactorrhea. Mastodynia frequently co-occurs with mammoplasia.

<span class="mw-page-title-main">Methaniazide</span> Chemical compound

Methaniazide, brand name Neotizide among others, is an antibiotic which was used in the treatment of tuberculosis. It is a derivative of methanesulfonic acid and isoniazid, which is also an antituberculosis drug but has comparatively been far more widely known and used. Isoniazid is a prodrug of isonicotinic acid, and acetylisoniazid, a metabolite of isoniazid, is a metabolic intermediate through which most of the isonicotinic acid is formed. Methaniazide features its mesylate group at the same position as that of the acetyl group in acetylisoniazid, and so methaniazide probably acts as a prodrug of isonicotinic acid similarly to isoniazid and acetylisoniazid. Methaniazide is used as the sodium salt. It was never approved for use or sale in the United States.

Fat removal procedures are used mostly in cosmetic surgery with the intention of removing unwanted adipose tissue. The procedure may be invasive, as with liposuction, or noninvasive using laser therapy, radiofrequency, ultrasound or cold to reduce fat, sometimes in combination with injections.

<span class="mw-page-title-main">Nipple-sparing mastectomy</span> Breast cancer treating method

Nipple-sparing mastectomy (NSM), also known as nipple delay, is one of the surgical approaches for treating or preventing breast cancer. It involves the removal of all breast tissue, except the nipple-areolar complex (NAC), and the creation of new circulatory connections from the breast skin to NAC. By preserving the NAC, NSM has provided patients with higher cosmetic expectations and the opportunity to undergo a mastectomy while maintaining a more natural appearance.

References

  1. ↑ Ohlsén, L.; Ericsson, O.; Beausang-Linder, M. (1996). "Rapid, massive and unphysiological breast enlargement". European Journal of Plastic Surgery. 19 (6). doi:10.1007/BF00180324. S2CID   19355441.
  2. ↑ Palmuth, T (1648), Observations medicuarum centinae tres posthumae, vol. Cent II, Braunschweig
  3. ↑ Dafydd, H.; Roehl, K.R.; Phillips, L.G.; Dancey, A.; Peart, F.; Shokrollahi, K. (2011). "Redefining gigantomastia". Journal of Plastic, Reconstructive & Aesthetic Surgery. 64 (2): 160–3. doi:10.1016/j.bjps.2010.04.043. PMID   20965141.
  4. ↑ To Wo Chiu (2011). Stone's Plastic Surgery Facts and Figures (3rd ed.). Cambridge University Press. p. 188.
  5. ↑ Syed A. Hoda; Edi Brogi; Fred Koerner; Paul Peter Rosen (5 February 2014). Rosen's Breast Pathology. Wolters Kluwer Health. pp. 152–. ISBN   978-1-4698-7070-0.
  6. 1 2 Note: the criterion of >600g is used with the term "macromastia" in this source: Sharma, K; Nigam, S; Khurana, N; Chaturvedi, KU (2004). "Unilateral gestational macromastia--a rare disorder". The Malaysian Journal of Pathology. 26 (2): 125–8. PMID   16329566.
  7. ↑ Dancey, Anne; Khan, M.; Dawson, J.; Peart, F. (2008). "Gigantomastia – a classification and review of the literature". Journal of Plastic, Reconstructive & Aesthetic Surgery. 61 (5): 493–502. doi:10.1016/j.bjps.2007.10.041. ISSN   1748-6815. PMID   18054304.
  8. ↑ "Puberty Stages of Development". Ask the Expert FAQs. OBGYN.net. Archived from the original on 2006-05-02. Retrieved 2006-11-21.
  9. 1 2 3 4 5 Casciola, Cheri (June–July 2005). "Gigantomastia". Leaven. 41 (3). Chandler, Arizona: 62–63. Archived from the original on October 4, 2017. Retrieved October 26, 2009.
  10. ↑ Kupfer D, Dingman D, Broadbent R (August 1992). "Juvenile breast hypertrophy: report of a familial pattern and review of the literature". Plast. Reconstr. Surg. 90 (2): 303–9. doi:10.1097/00006534-199290020-00023. PMID   1631223.
  11. ↑ Rezai, Shadi; Nakagawa, Jenna T.; Tedesco, John; Chadee, Annika; Gottimukkala, Sri; Mercado, Ray; Henderson, Cassandra E. (2015). "Gestational Gigantomastia Complicating Pregnancy: A Case Report and Review of the Literature". Case Reports in Obstetrics and Gynecology. 2015: 1–10. doi: 10.1155/2015/892369 . ISSN   2090-6684. PMC   4680110 . PMID   26713166.
  12. ↑ Juan, Ph.D., Stephen (January 13, 2007). "Is it true that a woman's breasts can grow enormously overnight?". The Register U.K. Retrieved 2011-08-16.
  13. 1 2 Swelstad MR, Swelstad BB, Rao VK, Gutowski KA (September 2006). "Management of gestational gigantomastia". Plast. Reconstr. Surg. 118 (4): 840–8. doi:10.1097/01.prs.0000232364.40958.47. PMID   16980844. S2CID   21477770.
  14. ↑ Moss WM (January 1968). "Gigantomastia with pregnancy. A case report with review of the literature". Arch Surg. 96 (1): 27–32. doi:10.1001/archsurg.1968.01330190029007. PMID   5635401.
  15. ↑ van der Meulen AJ (July 1974). "An unusual case of massive hypertrophy of the breasts". S. Afr. Med. J. 48 (34): 1465–6. PMID   4136526.
  16. ↑ Cheung KL, Alagaratnam TT (1997). "Pregnancy-related gigantomastia. Case report". Arch. Gynecol. Obstet. 259 (2): 87–9. doi:10.1007/bf02505314. PMID   9059749. S2CID   19285744.
  17. ↑ C. J. Dewhurst (1981). "Miscellaneous Disorders Complicating Pregnancy". In C. J. Dewhurst (ed.). Integrated Obstetrics and Gynaecology for Postgraduates (1 ed.). Blackwell Scientific Publications. pp. 334–352. ISBN   9780632006847. OCLC   8252620. The reduction in size of the breasts after delivery [in women with massive breast enlargement of pregnancy] may be incomplete and the patient may be left with very large breasts indeed, for which plastic surgical treatment should be considered.
  18. 1 2 Das, Liza; Rai, Ashutosh; Vaiphei, Kim; Garg, Akhil; Mohsina, Subair; Bhansali, Anil; Dutta, Pinaki; Tripathy, Satyaswarup (2019). "Idiopathic gigantomastia: newer mechanistic insights implicating the paracrine milieu". Endocrine. 66 (2): 166–177. doi:10.1007/s12020-019-02065-x. ISSN   1355-008X. PMID   31502211. S2CID   201989138.
  19. ↑ Merlob, Paul (2018). "Congenital Malformations and Developmental Changes of the Breast: A Dysmorphological View". Nipple-Areolar Complex Reconstruction. pp. 31–45. doi:10.1007/978-3-319-60925-6_2. ISBN   978-3-319-60924-9.
  20. ↑ Mick, G. J.; McCormick, K. L.; Wakimoto, H. (1991). "Massive breast enlargement in an infant girl with central nervous system dysfunction". European Journal of Pediatrics. 150 (3): 154–157. doi:10.1007/BF01963555. ISSN   0340-6199. PMID   2044582. S2CID   24172907.
  21. ↑ Zinn, Harry L.; Haller, J. O.; Kedia, Sanjay (1999). "Macromastia in a newborn with Alagille syndrome". Pediatric Radiology. 29 (5): 331–333. doi:10.1007/s002470050601. ISSN   0301-0449. PMID   10382209. S2CID   21758333.
  22. ↑ Noczyńska A, Wasikowa R, Myczkowski T (2001). "[Hypersensitivity of estrogen receptors as a cause of gigantomasty in two girls]". Pol. Merkur. Lekarski (in Polish). 11 (66): 507–9. PMID   11899849.
  23. ↑ Zhong, Aimei; Wang, Guohua; Yang, Jie; Xu, Qijun; Yuan, Quan; Yang, Yanqing; Xia, Yun; Guo, Ke; Horch, Raymund E.; Sun, Jiaming (2014). "Stromal-epithelial cell interactions and alteration of branching morphogenesis in macromastic mammary glands". Journal of Cellular and Molecular Medicine. 18 (7): 1257–1266. doi:10.1111/jcmm.12275. ISSN   1582-1838. PMC   4124011 . PMID   24720804.
  24. ↑ Kulkarni, Dhananjay; Beechey-Newman, N.; Hamed, H.; Fentiman, I.S. (2006). "Gigantomastia: A problem of local recurrence". The Breast. 15 (1): 100–102. doi:10.1016/j.breast.2005.03.002. ISSN   0960-9776. PMID   16005231.
  25. 1 2 3 4 Moschella, Francesco; Cordova, Adriana; Toia, Francesca (2016). "Gigantomastia". International Textbook of Aesthetic Surgery: 239–245. doi:10.1007/978-3-662-46599-8_18. ISBN   978-3-662-46598-1.
  26. ↑ Shozu, Makio; Fukami, Maki; Ogata, Tsutomu (2014). "Understanding the pathological manifestations of aromatase excess syndrome: lessons for clinical diagnosis". Expert Review of Endocrinology & Metabolism. 9 (4): 397–409. doi:10.1586/17446651.2014.926810. ISSN   1744-6651. PMC   4162655 . PMID   25264451.
  27. ↑ Martin, Regina M.; Lin, Chin J.; Nishi, Mirian Y.; Billerbeck, Ana Elisa C.; Latronico, Ana Claudia; Russell, David W.; Mendonca, Berenice B. (2003). "Familial Hyperestrogenism in Both Sexes: Clinical, Hormonal, and Molecular Studies of Two Siblings". The Journal of Clinical Endocrinology & Metabolism. 88 (7): 3027–3034. doi:10.1210/jc.2002-021780. ISSN   0021-972X. PMID   12843139.
  28. ↑ Rahman GA, Adigun IA, Yusuf IF (2010). "Macromastia: a review of presentation and management". Niger Postgrad Med J. 17 (1): 45–9. doi: 10.4103/1117-1936.181422 . PMID   20348982. S2CID   5742903.
  29. ↑ Dellal, Fatma Dilek; Ozdemir, Didem; Aydin, Cevdet; Kaya, Gulfem; Ersoy, Reyhan; Cakir, Bekir (2016). "Gigantomastia and Macroprolactinemia Responding to Cabergoline Treatment: A Case Report and Minireview of the Literature". Case Reports in Endocrinology. 2016: 1–5. doi: 10.1155/2016/3576024 . ISSN   2090-6501. PMC   4852364 . PMID   27195157.
  30. ↑ Roy, Mélissa; Lee, James; Aldekhayel, Salah; Dionisopoulos, Tassos (2015). "Pseudoangiomatous Stromal Hyperplasia". Plastic and Reconstructive Surgery Global Open. 3 (9): e501. doi:10.1097/GOX.0000000000000468. ISSN   2169-7574. PMC   4596426 . PMID   26495214.
  31. ↑ Li G, Robinson GW, Lesche R, Martinez-Diaz H, Jiang Z, Rozengurt N, Wagner KU, Wu DC, Lane TF, Liu X, Hennighausen L, Wu H (2002). "Conditional loss of PTEN leads to precocious development and neoplasia in the mammary gland". Development. 129 (17): 4159–70. doi:10.1242/dev.129.17.4159. PMID   12163417.
  32. ↑ Genzer-Nir, Mira; Khayat, Morad; Kogan, Leonid; Cohen, Hector I; Hershkowitz, Miriam; Geiger, Dan; Falik-Zaccai, Tzipora C (2010). "Mammary-digital-nail (MDN) syndrome: a novel phenotype maps to human chromosome 22q12.3–13.1". European Journal of Human Genetics. 18 (6): 662–667. doi:10.1038/ejhg.2009.236. ISSN   1018-4813. PMC   2987341 . PMID   20145678.
  33. ↑ David J. Dabbs (2012). Breast Pathology. Elsevier Health Sciences. pp. 19–. ISBN   978-1-4377-0604-8.
  34. ↑ Jabaiti, Samir; Fayyad, Luma; Isleem, Ula (2019-01-01). "Prednisolone-induced virginal mammary hypertrophy: Case report". International Journal of Surgery Case Reports. 59: 140–143. doi: 10.1016/j.ijscr.2019.04.042 . ISSN   2210-2612. PMC   6541761 . PMID   31146195.
  35. ↑ Baker, Stephen B.; Burkey, Brooke A.; Thornton, Paul; Larossa, Don (2001). "Juvenile Gigantomastia: Presentation of Four Cases and Review of the Literature". Annals of Plastic Surgery. 46 (5): 517–25, discussion 525–6. doi:10.1097/00000637-200105000-00011. PMID   11352426. S2CID   13015277.
  36. ↑ Ezem, B. U.; Osuagwu, C. C.; Opara, K. A. (2011). "Gestational gigantomastia with complete resolution in a Nigerian woman". BMJ Case Reports. 2011: bcr0120102632. doi:10.1136/bcr.01.2010.2632. PMC   3062818 . PMID   22707463.
  37. ↑ Bloom, Sara A.; Nahabedian, Maurice Y. (2008). "Gestational Macromastia: A Medical and Surgical Challenge". The Breast Journal. 14 (5): 492–5. doi: 10.1111/j.1524-4741.2008.00628.x . PMID   18657144. S2CID   29713936.
  38. ↑ Kulkarni, Dhananjay; Beechey-Newman, N.; Hamed, H.; Fentiman, I.S. (2006). "Gigantomastia: A problem of local recurrence". The Breast. 15 (1): 100–2. doi:10.1016/j.breast.2005.03.002. PMID   16005231.
  39. ↑ Dellal, Fatma Dilek; Aydin, Cevdet; Kaya, Mina Gulfem; Ersoy, Reyhan; Cakir, Bekir (2014). "A case with macroprolactinemia and gigantomastia responding to cabergoline treatment". Endocrine Abstracts. doi:10.1530/endoabs.35.P878. ISSN   1479-6848.
  40. ↑ Arscott GD, Craig HR, Gabay L (2001). "Failure of bromocriptine therapy to control juvenile mammary hypertrophy". Br J Plast Surg. 54 (8): 720–3. doi: 10.1054/bjps.2001.3691 . PMID   11728119.
  41. ↑ Ismail Jatoi; Manfred Kaufmann (11 February 2010). Management of Breast Diseases. Springer Science & Business Media. pp. 47–. ISBN   978-3-540-69743-5.
  42. ↑ Stoller, Evy Pitt; Geisinger, Gabriella (2018-02-23). "The Size of My Breasts Never Let Me Have the Body I Wanted". Tonic. Retrieved 2019-04-01.
  43. ↑ "I'm Sick Of The Way My Breast Size Affects My Career". fairygodboss.com. Retrieved 2019-04-01.
  44. ↑ Reynolds, Gretchen (2019-03-06). "How Breast Size Affects How Women Exercise". The New York Times. ISSN   0362-4331 . Retrieved 2019-04-01.
  45. ↑ Ellis, Stacy Ann (2013-08-22). "A Love-Hate Relationship: My Large Chest And The Negative Attention That Comes With It". MadameNoire. Retrieved 2019-04-01.
  46. 1 2 Morimoto, Tadaoki; Komaki, Kansei; Mori, Toshiaki; Sasa, Mitsunori; Miki, Hitoshi; Inoue, Hiroyuki; Monden, Yasumasa; Nakanishi, Hideki (1993). "Juvenile gigantomastia: Report of a case". Surgery Today. 23 (3): 260–4. doi:10.1007/BF00309238. PMID   8467179. S2CID   37288399.
  47. ↑ Rosen, Marjorie (April 26, 1993). "Now I Can Be Free". Vol. 39, No. 16. People Magazine. Retrieved 2009-09-12.
  48. ↑ Iwuagwu, Obi; Bajalan, Ahmed; Platt, Alastair; Stanley, Paul; Reese, Richard; Drew, Philip (2006-10-01). "Macromastia and Carpal Tunnel Syndrome: Is There an Association?". Aesthetic Plastic Surgery. 30 (5): 535–537. doi:10.1007/s00266-005-0214-x. ISSN   1432-5241. PMID   16858658. S2CID   189870808.
  49. ↑ "Too Much of a Good Thing?". Seattle Woman Magazine. Retrieved 2013-03-14.
  50. ↑ Fahmy, Fahmy S.; Saleh, Mohamed Ahmed Amin (2013), Shiffman, Melvin A.; Di Giuseppe, Alberto (eds.), "Reduction Mammoplasty: "The Piece of Art"", Cosmetic Surgery: Art and Techniques, Berlin, Heidelberg: Springer, pp. 755–774, doi:10.1007/978-3-642-21837-8_45, ISBN   978-3-642-21837-8 , retrieved 2024-08-21
  51. 1 2 Meli, Nico Bertoloni (2015). "Visual Representations of Disease: The Philosophical Transactions and William Cheselden's Osteographia". Huntington Library Quarterly. 78 (2): 157–186. doi:10.1353/hlq.2015.0026. ISSN   1544-399X.
  52. ↑ Durston, W.; Darston, W. (1669). "An Extract of a Letter Written to the Publisher from Plymouth Novem. 2. 1669. By William Durston Dr. Of Physick; Concerning the Death of the Bigg-Breasted Woman (Discoursed of in Numb. 52.) Together with what Was thereupon Observed in Her Body". Philosophical Transactions of the Royal Society. 4 (45–56): 1068–1069. Bibcode:1669RSPT....4.1068D. doi: 10.1098/rstl.1669.0048 .
  53. ↑ Qua, Lam (April 17, 1848). "Peter Parker Collection". Medical Historical Library, Cushing/Whitney Medical Library. Archived from the original on 13 August 2009. Retrieved 21 March 2010.
  54. ↑ Rahman, G. A.; Adigunt, I. A.; Yusuf, I. F.; Bamigbade, D. P. (1 July 2007). "Macromastia and bilateralaxillary breast hypertrophy: a case report". West African Journal of Medicine. 26 (3): 250–252. doi: 10.4314/wajm.v26i3.28321 . PMID   18399346.
  55. ↑ Borsetti, G.; Merlino, G.; Bergamin, F.; Cerato, C.; Boltri, M.; Borsetti, M. (2009). "A 38 kg skin-reducing bilateral mastectomy: A unique case". Journal of Plastic, Reconstructive & Aesthetic Surgery. 62 (1): 133–134. doi:10.1016/j.bjps.2008.03.067. PMID   18694661.
  56. ↑ Antevski, Borce; Jovkovski, Oliver; Filipovski, Vanja; Banev, Saso (2010). "Extreme gigantomastia in pregnancy: Case report—my experience with two cases in last 5 years". Archives of Gynecology and Obstetrics. 284 (3): 575–8. doi:10.1007/s00404-010-1714-8. PMID   20978777. S2CID   20169309.
  57. 1 2 "Macedonia faces 'giant' breast problem". Archived from the original on August 3, 2012.
  58. ↑ "Jasna Galleguillos" (in Spanish). El Mercurio de Antofagasta. 2007.
  59. ↑ "Pilma's heavy burden". October 29, 2009. Retrieved 22 March 2010.
  60. ↑ Fiumara, Linda; Gault, David T.; Nel, Mark R.; Lucas, Dominique N.; Courtauld, Elizabeth (2009). "Massive bilateral breast reduction in an 11-year-old girl: 24% ablation of body weight". Journal of Plastic, Reconstructive & Aesthetic Surgery. 62 (8): e263-6. doi:10.1016/j.bjps.2007.10.053. PMID   18291739.

Further reading

This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.