Summary
Megalomastia is a rare entity characterized by an uncommon enlargement of both breasts. Unilateral megalomastia is extremely rare. The purpose of this study was to collect information concerning the history of patients with this condition and to investigate its histology in order to outline the profile of this peculiar entity. Fifty cases of megalomastia were studied. In 41 data concerning the history of the patients was complete; there were 32 juvenile, 7 gravid and 2 adult type cases. All three unilateral megalomastias were in the juvenile group. A family history of megalomastia was frequently present; gravid megalomastia was more closely connected with a maternal familial history. A case of simultaneous megalomastia in monozygotic twins is included. The final size achieved by the breasts was independent of the type of megalomastia, the rapidity of breast development and the body weight of the patients. It was greater in breasts containing abundant adipose tissue and less in fibrous breasts. In all cases of megalomastia associated with pregnancy the breasts had lost the ability to produce milk. The main histological feature in all cases was severe damage and destruction of the lobular units associated with extensive fibrosis. In some breasts of all three types of megalomastia ramified new ducts named “juvenile units” had developed and had proceeded to atrophy. Immunohistochemistry revealed that the epithelium of these units was negative for oestrogen and positive to progesterone receptors. A biphasic pathological appearance, consisting of atrophic lobular units and “juvenile units”, is diagnostic of megalomastia.
Similar content being viewed by others
References
Bässler R (1978) Pathologie der Brustdrüse. In: Doerr W, Seifert G, Uehlinger E (eds) Spezielle pathologische Anatomie, vol 11. Springer, Berlin Heidelberg New York, p 292
Bauer BS, Joyes KM, Tablot CW (1987) Mammary masses in the adolescent female. Surg Gynecol Obstet 165:63–65
Beischer NA, Hueston JH, Pepperell RJ (1989) Massive hypertrophy of the breasts in pregnancy: report of 3 cases and review of the literature “never think you have seen everything”. Obstet Gynecol Surv 44:234–243
Bhattacharya P (1983) Pregnancy with huge bilateral hypertrophic axillary tail of the breast. Case report. Br J Obstet Gynecol 90:874–875
Birkenfeld W (1932) Beitrag zur Zwillingspathologie der Mamma. Arch Klin Chir 168:568–576
Boyce SW, Hoffman PG, Mathes SJ (1984) Recurrent macromastia after subcutaneous mastectomy. Ann Plast Surg 13:511–518
D'Alessandro DR, Taylor FM (1986) Unilateral breast enlargement due to localized fibrosis. South Med J 79:1451–1453
De Castro CIC (1977) Subcutaneous mastectomy for gigantomastia in an adolescent girl. Case report. Plast Reconstr Surg 59:575–578
Durston W (1670) Concerning a very sudden and excessive swelling of a woman's breasts. Phil Trans R Soc Lond, IV:1047–1049
Fisher W, Smith JW (1971) Macromastia during puberty. Plast Reconstr Surg 47:445–451
Furnas DW (1982) Subcutaneous mastectomy for juvenile hypertrophy of the breast. Report of a case. Br J Plast Surg 35:367–370
Gargon TG, Coldwyn RM (1987) Gigantomastia complicating pregnancy. Case report. Plast Reconstr Surg 80:121–124
Gavrilescu VC, Cernea M, Pencea V, Stratulat S (1977) Über die Makromastie bei zwei klinischen Fällen. Zentralbl Gynakol 99:625–628
Geschickter CF (1945) Diseases of the breast. Lipincott, Philadelphia, p 119
Greeley PM, Robertson LE, Curtin JW (1965) Mastoplasty for massive bilateral benign breast hypertrophy associated with pregnancy: case report. Ann Surg 162:1081–1083
Griffith JR (1989) Virginal breast hypertrophy. J Adolesc Health Care 10:423–432
Haagensen CD (1986) Diseases of the breast, 3rd edn. Sauders, Philadelphia, pp 56–62
Hollingsworth DR, Archer R (1973) Massive virginal breast hypertrophy at puberty. Am J Dis Child 125:293–295
Hsu SM, Raine L, Fanger H (1981) The use of antiavidin antibody and avidin-biotin peroxidase complex immunoperoxidase technics. Am J Clin Pathol 75:816–821
Lafreniere R, Temple W, Ketcham A (1984) Gestational macromastia. Am J Surg 148:413–418
Leis SN, Palmer B, Ostberg G (1974) Gravid macromastia. Case report. Scand J Plast Reconstr Surg 8:247–249
Lewis D, Geschickter CF (1934) Gynecomastia, virginal hypertrophy and fibroadenomas of the breast. Ann Surg 100:779–795
Lewison EF, Trimble FH (1960) Gigantomastia complicating pregnancy. Surg Gynecol Obstet 110:215–223
Luschin-Ebengreuth G, Scharmagl E (1989) Ein Fall von Graviditatsmakromastie. Gynakol Rundsch 29 [Suppl 2]:335–337
Mayl N, Vasconez LO, Jurkiewich MJ (1974) Treatment of macromastia in the actively enlarging breast. Plast Reconstr Surg 54:6–12
Miller CJ, Becker DW (1979) Management of first trimester breast enlargement with necrosis. Plast Reconstr Surg 63:383–386
Ryan RF, Pernoll ML (1985) Virginal hypertrophy. Plast Reconstr Surg 75:737–742
Sagot P, Mainguene C, Barriere P, Lopes P (1990) Virginal breast hypertrophy at puberty: a case report. Eur J Obstet Gynecol Reprod Biol 34:289–292
Samuelov R, Siplovich L (1988) Juvenile gigantomastia. J Pediatr Surg 23:1014–1015
Ship AG (1986) Virginal and gravid breast hypertrophy. Plast Reconstr Surg 75:680–685
Staub S, Browski A, Vilain R (1989) Hypertrophic mammaire juvenile. Treatment chirurgical precose. Ann Chir Plast Esthet 34:269–272
Stavrides S, Hacking A, Tiltman A, Dent DM (1987) Gigantomastia in pregnancy. Br J Surg 74:585–586
Strombeck JO (1964) Macromastia in woman and its surgical treatment: a clinical study based on 1,064 cases. Thesis. Acta Clin Scand [Suppl] 341:5–125
Tchabo JG, Stay EJ (1989) Gravid macromastia: case report. Am J Obstet Gynecol 160:88–89
Van Heerden JA, Glarib H, Jackson JT (1988) Pseudohyperparathyroidism secondary to gigantic mammary hypertrophy. Arch Surg 123:80–82
Williams PC (1957) Massive hypertrophy of the breasts and axillary breasts in successive pregnancies. Am J Obstret Gynecol 74:1326–1329
Zienert A (1990) Makromastie in der Schwangerschaft:Normalität oder Komplikation? Zentrlbl Gynakol 112:1303–1307
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Anastassiades, O.T., Choreftaki, T., Ioannovich, J. et al. Megalomastia: histological, histochemical and immunohistochemical study. Vichows Archiv A Pathol Anat 420, 337–344 (1992). https://doi.org/10.1007/BF01600213
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01600213