Macromastia: an Overview
Macromastia is an excessive growth of the breasts. Macromastia is a synonym for breast hypertrophy and gigantomastia. Macromastia's ICD / ICD 10 code is "N62" (Hypertrophy of breast).
What is the criteria for the diagnosis of Macromastia?
Another definition of Macromastia is: an excess weight of the breasts equivalent to or greater than 3% of the total body weight of the subject.
What is Macromastia ICD 10 code?
Macromastia's ICD-10-CM code is N62.
Macromastia is so rare that there are very few published studies about the condition. However, there is no specific cause for this type of growth. It can occur at different stages, such as the pubertal stage (puberty) and during pregnancy. In even fewer observed cases, it's due to the use of medications such as LH-RH hormone antagonists and anti-androgens. There are also cases due to genetic predisposition.
The amount of time it takes for this growth to occur may vary. Some cases are noticeable in a matter of years, but some women notice an increase in breast size in weeks.
The symptoms mainly include back pain (dorsalgia and lumbago) due to the same postural problem and mastalgia (breast pain). There are also medical reports of infections.
Among the most common treatments, we have surgical procedures done by surgeons specializing in cosmetic and reconstructive surgery. However, most cases resolve independently, and treatment is usually unnecessary.
What are the different types of macromastia?
There are five main recognized types of Macromastia:
- Juvenile macromastia: It happens in the pubertal stage (puberty).
- Gestational macromastia: Related to excessive breast growth during pregnancy.
- Drug-induced macromastia: occurs as a result of taking certain medications that can alter the feedback mechanisms of the hormonal axes and cycles. Other drugs reduce or suppress androgens, "male" hormones needed to maintain female health; these drugs that induce high levels of female and growth hormones, may cause macromastia.
- Idiopathic or primary macromastia: Meaning it has no obvious origin. It's the most frequent type of macromastia.
- Gigantomastia: Is also defined as an excessive breast growth but to fall under this category the excess tissue must have a weight of at least five pounds.
What causes macromastia?
The list of possible causes for macromastia is small, considering that primary or idiopathic macromastia is the leading one; that is, when there is no obvious suspected cause. Other causes may include:
- Extreme obesity
- Drugs, particularly LH-RH blockers, anti-androgens, and antibiotics such as penicillin and bucillamine
- Immunological: Diseases of the thyroid gland (Hashimoto's thyroiditis), systemic lupus erythematosus, myasthenia gravis, chronic arthritis, and psoriasis.
How common is macromastia?
It's a rare condition, even for gynecologists and mastologists (sub-specialists in pathologies of the breasts). There are about 300 reported cases, and all have been benign (not cancerous).
- The cardinal symptom is the excessive increase of the breasts that can be in one (unilateral) or, more frequently, in both (bilateral) of them.
- Mastalgia (breast pain)
- Dorsalgia, lower back pain, and possibly shoulder and neck pain due to the weight of the breasts that modifies the body's natural posture
- Bad posture
- Itching, temperature changes (heat), and redness
- Decreased sensitivity or loss of sensation in the nipples
- Infections and abscesses
- Lesions or infections under the breasts
- Painful lesions and stretch marks in the bra strap area
How is macromastia diagnosed?
When consulting a medical doctor or specialist, the physician may ask about your medical history. The physician may ask questions to collect essential data, including the reasons for consultation, when the symptoms started, your previous clinical history, medications you take, and relatives with similar symptoms, particularly your mother, maternal and paternal grandmothers, and, in some cases, sisters and maternal and paternal aunts.
Next, the physician will likely perform a physical examination in which a breast examination will be necessary. If the diagnosis of macromastia is suspected, pertinent tests can be indicated, including a hormonal profile and imaging (ultrasound of both breasts or mammography).
Some characteristics used to diagnose macromastia include:
- The size of your breasts as well as the timeline and rate of growth.
- The date of your first menstruation to determine if there was precocious puberty.
- Possible pregnancy.
- Drugs or medications taken that may lead to suspicion of macromastia.
Macromastia: Treatment options
Currently, there is no standardized treatment for macromastia. However, the first thing to consider is to rule out other pathologies that can range from infections and pregnancy to cases of malignancy in the breasts (breast cancer).
After your doctor has ruled out any other pathology of macromastia, they may suggest or refer you to a specialist in plastic surgery (aesthetic-reconstructive) to perform what would be a reduction of the excessive size of the breasts (reductive mastectomy).
- Bromocriptine: It might slow down or stop breast growth.
- Tamoxifen: Frequently used in breast cancer.
- Danazol: Common in endometriosis and fibrocystic breast disease.
Macromastia: Are there complications?
Macromastia can cause infections and physical and psychological problems in women affected by this rare condition. Other possible complications:
- Breast asymmetry
- Tight and sensitive skin
- Loss of sensation in the nipples
- Difficulty breastfeeding
- Back, neck, and shoulder pain
- Postural problems
- Damage to the intercostal nerves (the cause of little or no nipple sensation)
- Difficulty practicing sports or exercising
- Body dysmorphia
- Avoidance of social activities and isolation
- Breast milk suppression
- Reduced fetal growth
- Spontaneous abortion
- Infections and breast abscesses
- Cracks, lesions, and stretch marks on the skin of the breasts
How can I reduce my risk of macromastia?
It's difficult to determine the cause of macromastia and even more challenging to prevent it. Since the leading cause is idiopathic and associated with genetic factors, more in-depth studies are usually required.
What can I expect if I am diagnosed with macromastia?
Macromastia is a condition that causes discomfort and pain, both physically and mentally. Ideally, you should consult a physician as soon as the cardinal symptoms become noticeable. Your primary doctor is the ideal person to guide you in finding the best solution.
What is the prognosis for Macromastia patients?
Macromastia requires treatment as soon as possible because it can cause breast pain, severe posture problems, and daily back pain that may incapacitate the patient.
Macromastia may affect mental and physical health, cause infections that may be difficult to treat, and cause problems during pregnancy and breastfeeding. Even though macromastia is benign, any other pathology that may increase breast volume must be ruled out, including breast cancer.
There are few registered cases of emergency mastectomies for macromastia; usually performed in cases where the spine is compromised. Generally, macromastia-related surgeries are elective surgeries.
Reductive mastectomy is the primary treatment course for macromastia in most cases. It's highly effective if plastic and reconstructive surgery specialists perform the procedure. During puberty, there is the possibility for recurrence of breast growth, so even though a mastectomy is possible, it might be advisable to wait; unless the volume of the breasts increases rapidly. Another situation in which plastic surgery may not be effective (or practical) is during pregnancy.
Who are the top experts researching treatments for macromastia?
The top experts researching macromastia are: Ximena A. Pinell and Wojciech Dec.
What are the top concepts researched in studies about macromastia?
The most researched concepts in studies of macromastia are: Breast Surgery, Inferior Pedicle, Surgical Technique, Plastic Surgeons, Radiation Therapy and Latissimus Dorsi..
What are some of the top places that specialize in macromastia?
Recommended institutions that specialize in macromastia:
- Houston Methodist Department of Surgery - Breast Surgery6550 Fannin St Suite 1501, Houston, TX 77030 Phone: 17134415141
- Breast Reduction Center Los Angeles436 N Bedford Dr #102, Beverly Hills, CA 90210 Phone: 14242023743
- Paul Harris5 Devonshire Pl, London W1G 6HL, United Kingdom Phone: 442079276520
- Gary Ross - Cosmetic & Plastic Surgeon ManchesterThe Christie Clinic, 550 Wilmslow Road, Manchester M20 4BX, United Kingdom Phone: 441614014037
Recent articles about Macromastia
The Impact Of Macromastia On Adolescents: A Cross-Sectional Study
.. of macromastia on adolescents considering reduction mammaplasty in comparison with healthy adolescents.
METHODS: The following surveys were administered to adolescents with macromastia and ...
Known for Adolescents Macromastia | Bmi Category | Rosenberg Selfesteem Scale | Case Status | Survey Score
Reduction Mammoplasty Improves Breast Conservation Therapy In Patients With Macromastia
.. BACKGROUND: Macromastia has been considered a contraindication to breast conservation therapy because of difficulties with radiation therapy. This study evaluates the feasibility of ...
Known for Breast Conservation Therapy | Reduction Mammoplasty | Patients Macromastia | Completion Mastectomy | Median Weight
Macromastia And Carpal Tunnel Syndrome: Is There An Association?
Macromastia is a disorder commonly reported by women. The prevalence of electrophysiologically confirmed, symptomatic carpal tunnel syndrome is 3% among women. A consecutive series of 31 ...
Known for Carpal Tunnel Syndrome | Women Age | Breast Size | Patients Macromastia | Adult Body
Macromastia As An Etiologic Factor In Bulimia Nervosa
.. symptomatic macromastia. All patients reported that dysfunctional eating habits where in part the result of breast enlargement. Five patients underwent reduction mammaplasty and ...
Known for Bulimia Nervosa | Disorders Patients | Eating Disorder | Physical Symptoms | Mammaplasty Patient
Early Complications Of A Reduction Mammoplasty Technique In The Treatment Of...
This study was planned to investigate the early postoperative complications of reduction mammoplasty done for benign or malignant reasons on 286 patients. Minor and major complication rates ...
Known for Breast Cancer | Reduction Mammoplasty | Complication Rates | Surgical Wound | Patients Macromastia
Macromastia In Adolescence
Macromastia is a deforming, disabling, and painful condition, especially in the adolescent. Multiple procedures have been advocated and are successful for the reduction of breast tissue. In ...
Known for Breast Tissue | Condition Adolescent | Diseases Female | Patient Counseling
Breast Reduction As An Alternative Treatment Option For Early Breast Cancer In...
Macromastia has been considered a relative contraindication to breast conservation therapy because of difficulties with postoperative radiation therapy and cosmesis. This study evaluates the ...
Known for Breast Reduction | Alternative Treatment Option | Postoperative Complications | Retrospective Review | Conservation Therapy
Dual-Plane Prosthetic Reconstruction Using The Modified Wise Pattern Mastectomy...
.. with macromastia is often difficult. The Wise pattern skin-reducing mastectomy often provides the best options for shape and symmetry, but is not without morbidity. The authors reviewed ...
Known for Wise Pattern | Tissue Expander | Women Macromastia | Mastectomy Breast | Postoperative Complications
The Effect Of Reduction Mammaplasty On Quality Of Life In Adolescents With Macromastia
.. with macromastia and 84 female controls, aged 12 to 21 years. Patients with macromastia completed surveys preoperatively and after reduction mammaplasty at 6 months and 1, 3, and 5 years. ...
Known for Reduction Mammaplasty | Life Adolescents | Healthrelated Quality | 6 Months | Eating Attitudes
The Benefits Of Partial Versus Total Breast Reconstruction For Women With Macromastia
.. with macromastia is challenging. Complication rates are often higher, and cosmetic results are less favorable. The study compared partial and total breast reconstruction in women with ...
Known for Breast Reconstruction | Complication Rates | Oncoplastic Reduction | 51 Patients | Sparing Mastectomy