Breast hypertrophy

Last updated: November 9, 2023

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Summarytoggle arrow icon

Breast hypertrophy is a rare condition that is characterized by abnormal breast enlargement due to excessive tissue growth. Although usually idiopathic, hormonal etiologies include aromatase excess syndrome, hyperprolactinemia, and increased sensitivity to estrogen and progesterone. Clinical features include disproportionately large breasts, mastalgia, inframammary intertrigo, trapezius hypertrophy, and neck, shoulder, and upper back pain. Breast hypertrophy is a clinical diagnosis; laboratory studies and imaging may be indicated to evaluate for an underlying etiology or to rule out other diagnoses. Surgical breast reduction (reduction mammoplasty) is the mainstay of treatment for symptomatic breast hypertrophy. Conservative measures (e.g., proper breast support, upper body physiotherapy) and pharmacotherapy are alternatives when surgery is not feasible.

Definitiontoggle arrow icon

Etiologytoggle arrow icon

Clinical featurestoggle arrow icon

Diagnosticstoggle arrow icon

Breast hypertrophy is a clinical diagnosis based on features consistent with disproportionately large breasts for the individual's body. [5][6]

Clinical assessment

Laboratory studies [3][7]

Imaging [3][7][8]

Managementtoggle arrow icon

Surgery [3][5]

Conservative management [5][7]

Consider alternatives to progestin-containing contraception in adolescents. Exogenous progestin-only contraception may initially exacerbate breast hypertrophy, but it is not associated with continued breast tissue growth. [9]

Referencestoggle arrow icon

  1. Degeorge BR Jr, Colen DL, Mericli AF, Drake DB. Reduction mammoplasty operative techniques for improved outcomes in the treatment of gigantomastia.. Eplasty. 2013; 13: p.e54.
  2. Wolfswinkel E, Lemaine V, Weathers W, Chike-Obi C, Xue A, Heller L. Hyperplastic Breast Anomalies in the Female Adolescent Breast. Semin Plast Surg .. 2013; 27 (01): p.049-055.doi: 10.1055/s-0033-1347167 . | Open in Read by QxMD
  3. Rahman GA, Adigun IA. Macromastia: a review of presentation and management.. Postgrad Med J. 2010; 17 (1): p.45-9.
  4. $Contributor Disclosures - Breast hypertrophy. All of the relevant financial relationships listed for the following individuals have been mitigated: Alexandra Willis (copyeditor, was previously employed by OPEN Health Communications). None of the other individuals in control of the content for this article reported relevant financial relationships with ineligible companies. For details, please review our full conflict of interest (COI) policy:.
  5. Perdikis G, Dillingham C, Boukovalas S, et al. American Society of Plastic Surgeons Evidence-Based Clinical Practice Guideline Revision: Reduction Mammaplasty. Plast Reconstr Surg. 2022; 149 (3): p.392e-409e.doi: 10.1097/prs.0000000000008860 . | Open in Read by QxMD
  6. Fonseca CC, Veiga DF, Garcia E da S, et al. Breast Hypertrophy, Reduction Mammaplasty, and Body Image. Aesthet Surg J. 2018; 38 (9): p.972-979.doi: 10.1093/asj/sjx271 . | Open in Read by QxMD
  7. Jones K, Pruthi S. Nonsurgical Management of Fibroadenoma and Virginal Breast Hypertrophy. Semin Plast Surg. 2013; 27 (01): p.062-066.doi: 10.1055/s-0033-1343997 . | Open in Read by QxMD
  8. Hoppe IC, Patel PP, Singer-Granick CJ, Granick MS. Virginal mammary hypertrophy: a meta-analysis and treatment algorithm.. Plast Reconstr Surg. 2011; 127 (6): p.2224-2231.doi: 10.1097/PRS.0b013e3182131bd1 . | Open in Read by QxMD
  9. Nuzzi LC, Pramanick T, Massey GG, et al. The Impact of Progestin-only Contraception on Adolescents with Macromastia. Plast Reconstr Surg Glob Open. 2021; 9 (2): p.e3421.doi: 10.1097/gox.0000000000003421 . | Open in Read by QxMD

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