Gigantomastia

What is gigantomastia?

Gigantomastia or breast hypertrophy is a rare condition that involves developing extremely large breasts due to excessive breast tissue growth. It affects people assigned female at birth. If you have gigantomastia, you’ll experience rapid and disproportionate breast growth. The speed at which your breasts grow can vary, from over a few weeks to over several years. The tissue is almost always benign (not cancerous).

Gigantomastia is characterized by:

• Breasts that have an excess of at least 5 pounds of breast tissue.
• Extra breast tissue that equals more than 3% of your total body weight.

It can happen during puberty, pregnancy or from taking medication. In some cases, it occurs spontaneously and for no reason.

Gigantomastia is also referred to as macromastia. However, macromastia is usually defined as excess breast tissue that weighs less than 5 pounds.

What are the different types of gigantomastia?

Healthcare providers classify gigantomastia into four types:

• Juvenile gigantomastia: This type happens during puberty.
• Gestational gigantomastia: This is when gigantomastia occurs during pregnancy.
• Drug-induced gigantomastia (or medication-induced): This happens after taking certain drugs.
• Idiopathic gigantomastia: This is when the cause of gigantomastia is unknown or can't be determined. Idiopathic gigantomastia is the most common type.

How common is gigantomastia?

It's an uncommon condition. Only about 300 cases have been reported.

What are the symptoms of gigantomastia?

Having extremely large breasts can be both physically and emotionally painful. Some of the most common symptoms of breast hypertrophy are:

• Infection or lesions on the skin of your breasts, especially under your breasts.
• Neck and back pain caused by your breasts pulling you down.
• Poor posture.
• Loss of feeling in the nipples.
• Breast pain (mastalgia).
• Painful and itchy indentations on your skin from the straps of your bra.

What causes extremely large breasts?

The cause of gigantomastia isn't entirely known; however, researchers think it may be influenced by:

• Hormonal changes (like during puberty or pregnancy).
• Medications like penicillamine or bucillamine.
• Autoimmune conditions like lupus or arthritis.
• Extreme obesity.
• Genetics.

How is it diagnosed?

Your healthcare provider will examine you and ask questions about your medical history. They will need to know how your breast size has changed, other symptoms you have, or if you're taking any medications. Further testing is usually not needed to confirm the diagnosis.

How is gigantomastia treated?

There isn’t a one-size-fits-all treatment for gigantomastia. You and your healthcare provider should discuss all the treatment options and weigh the risks and benefits of each.

Depending on the severity of your symptoms and the size of your breasts, your healthcare provider may recommend breast reduction surgery or medication to treat gigantomastia. In cases of recurring or severe gigantomastia, your healthcare provider may recommend a mastectomy.

What medications are used to treat gigantomastia?

Certain medications may stop the breast tissue from growing. Your healthcare provider may prescribe one of the following medications:

• Tamoxifen.
• Medroxyprogesterone.
• Danazol.
• Bromocriptine.

Sometimes this is all that is needed to reduce the growth of breast tissue. In other cases, it needs to be combined with breast reduction surgery.

What surgery treats gigantomastia?

Breast reduction surgery can treat gigantomastia. A surgeon makes an incision in your breasts and removes excess fat, tissue and skin. Once the desired breast size is reached, they will close the incision with stitches. Your nipple or areola may need repositioning to align with the new size and shape of your breasts. The surgery takes a few hours, and you may need to stay in the hospital overnight.

A mastectomy may be recommended in severe or recurrent cases of gigantomastia. This is where a surgeon removes your entire breast. Mastectomies carry risks and should be discussed with your healthcare provider.

How long does it take to recover from treatment?

You should expect some mild pain, swelling and bruising the first few days after breast reduction surgery. Your healthcare provider may prescribe antibiotics to prevent infection and pain relievers to help with discomfort. A follow-up appointment is scheduled to examine the breasts and remove any stitches. Most people recover and resume light activities in about a week. Your breasts will take their final shape and size once the swelling is gone. A small scar may be visible, but most surgeons will try to minimize any scarring.

If you have to have a mastectomy, your recovery can take up to one month. The exact recovery time varies depending on your age, medical conditions and other factors.

What are the complications of gigantomastia?

Gigantomastia can cause problems such as:

• Neck and back pain.
• Inability to walk, run or exercise.
• Infections of the skin around the bra area.
• Pain in the breasts.
• Breastfeeding (chestfeeding) issues.
• Itchy or inflamed skin.

In addition to these physical symptoms, extremely large breasts can lead to emotional and social issues like depression, anxiety or poor body image.

Gigantomastia can cause issues such as poor fetal growth, mastitis or low milk supply in those who are pregnant.

How can I reduce my risk for gigantomastia?

There's nothing you can do to reduce your risk of developing gigantomastia. Researchers are not entirely sure what causes it.

What can I expect if I have this condition?

Gigantomastia doesn't usually cause any serious complications. Depending on how severe your gigantomastia is, your symptoms can make daily life painful and uncomfortable. Talk to your healthcare provider about ways to reduce your symptoms or if breast reduction surgery is needed.

Will gigantomastia cause problems with breastfeeding (chestfeeding)?

Yes, it can be challenging to breastfeed if you have gigantomastia. Certain complications of breast hypertrophy like breast infections, blisters or sores, low milk supply and pain can cause problems with breastfeeding.

When should I see my healthcare provider?

Talk to your healthcare provider if you are experiencing any symptoms associated with gigantomastia. You shouldn't need to live with pain, discomfort and frustration from excessively large breasts. They may recommend surgery or medication to reduce the size of your breasts.

A note from Cleveland Clinic

Gigantomastia can be a physically and emotionally devastating condition. If you suffer from extremely large breasts, there are treatments that can relieve your pain. Be open and honest with your healthcare provider about your symptoms and what you are feeling. Together you can make the best decision on how to treat gigantomastia so that you can live more comfortably.