Gigantomastia is a condition in which one or both breasts are abnormally enlarged.
Gigantomastia can be caused by several factors, including hormonal changes due to pregnancy and the use of estrogen-progesterone contraceptives (birth control pills containing progesterone).
Other causes include polycystic ovary syndrome, tumors that produce human growth hormone or prolactin; certain drugs such as; phenothiazines/haloperidol, psychotropic agents like chlorpromazine, etc.
There are different theories of what causes gigantomastia, some say it happens during puberty, while others think the cause is pregnancy or certain medications.
The condition doesn’t occur in men and can result in great pain for women if left untreated.
It occurs over time with symptoms including large breasts that obstruct physical activity, infections & back problems.
What are the symptoms?
Women with gigantomastia may experience some difficulties that are related to their extremely large breasts.
These issues can include permanent, significant breast sagging and shape changes; chronic back pain due to the weight of the breasts on one’s spine;
shoulder grooving from bra straps over time (this occurs even if patients wear properly fitting supportive bras);
Breathing problems or sleep apnea stemming from fluid buildup in tissues around airways as well as impaired lung capacity created by enlarged mammary glands pressing against chest walls.
The main symptom of gigantomastia is an extreme growth of breast tissue either unilaterally or bilaterally which takes place gradually over a period of years.
But sometimes rapidly occurring within weeks too causing many women who suffer this condition more than just physical discomfort.
The pain and posture problems, which are usually caused by the excess weight of the breasts, should be addressed.
What causes it?
There are a number of factors that could potentially play a role in gigantomastia but the exact mechanism is still unknown.
There have been theories suggesting genetics, an increased sensitivity to female hormones like prolactin or estrogen as well as other environmental causes.
Some women who suffer from this condition and there doesn’t seem to be any specific cause for their breast enlargement and it happens spontaneously without warning.
Breasts can become enlarged due to variation between individuals with regard to mammary gland size.
What exactly triggers gigantomastia remains a mystery, though it’s thought to be related to genetics and an increase in female hormones.
Genetics is not well understood but should play a role because of increased sensitivity from prolactin or estrogen.
Female hormone changes trigger this which could happen for some people spontaneously due to unknown reasons.
Types of gigantomastia
Gigantomastia is a condition in which the breasts are enlarged beyond what’s considered normal.
The subtypes of this condition vary based on whether it was caused by an event or if there’s another reason for its development.
Types of gigantomastia include:
1. Gestational or pregnancy-induced gigantomastia: Gestational or pregnancy-induced gigantomastia occurs during the first trimester of a woman’s pregnancy. It is triggered by hormones, and it affects just 1 out of 100,000 pregnancies.
2. Puberty-induced or juvenile gigantomastia: Puberty-induced or juvenile gigantomastia is a rare condition of excessive breast growth in pubescent girls and boys.
In some cases, the breasts may continue to grow beyond puberty and become large enough that they cause back pain.
The exact etiology behind this disorder has not been fully elucidated but it presents itself most often during adolescence when estrogen production begins.
Resulting in an increase of ductal tissue within the breasts while at other times can be attributed more specifically toward conditions.
Such as McCune Albright syndrome which results from genetic mutation leading to overproduction of hormones by one gland.
3. Medication- or drug-induced gigantomastia: Medication- or drug-induced gigantomastia is a condition that occurs after taking certain medications. D-penicillamine, which is used to treat rheumatoid arthritis and cystinuria among other conditions, causes this effect most commonly.
4. Idiopathic gigantomastia: Idiopathic gigantomastia occurs when a woman’s breasts grow abnormally large, without any known cause. It is the most common type of this condition.
How is it diagnosed?
A medical and family history will be taken by your doctor, as well as a physical examination.
The following questions might be asked:
- Do you have any other symptoms?
- When was the date of your first menstruation?
- Have you taken medications recently that could affect diagnosis or treatment options for gigantomastia?
For example, if an adolescent is diagnosed with this condition soon after having her menarche it may suggest she has been taking birth control pills containing estrogen, which can make breast tissue grow excessively large.
Other diagnostic tests aren’t usually necessary unless there’s another underlying disorder suspected to cause gigantomastia in adolescents who do not take these types of medication.
A woman with gigantomastia is faced with a myriad of symptoms, including infection and pain.
To help manage the condition, doctors prescribe a case-by-case variety of antibiotics, warm dressings, and over-the-counter pain medications.
A patient might spontaneously reduce her breast size after giving birth but in most cases, surgery is recommended to remove excess fat tissue from breasts as large as basketballs.
After a breast reduction surgery, your doctor might prescribe one or more medications to help stop the growth of breasts. These may include;
- medroxyprogesterone: This can also be used.
- bromocriptine: a dopaminergic receptor agonist often used for Parkinson’s disease that has been shown to stop bra size from increasing.
- danazol, typically prescribed for endometriosis and symptoms related to fibrocystic diseases.
Are there complications?
The excess weight of the breasts can result in many physical complications including neck, shoulder, and back pain as well as nerve damage. However, all of these problems are temporary with only a few lasting long-term such as permanent loss of sensation or asymmetry between one breast size to another.
What is the outlook?
People with gigantomastia may also need surgery to reduce the size of their breasts. If not treated, this condition can cause dangerous infections and posture problems which can be physically disabling. Surgery is considered a safe and effective treatment for reducing breast size but it could reoccur after puberty or pregnancy-induced weight gain in some cases.