Macromastia: a review of presentation and management

Macromastia is a condition of abnormal enlargement of the breast tissue in excess of the normal proportion. The condition may be caused by glandular hypertrophy, excessive fatty tissue or combination of both. The usual physiologic enlargement of female breast occurs over 3 to 5 years and the female breast size is related to body habitus and hereditary characteristics.

A review of the literatures of Macromastia was undertaken with emphasis on presentation and management.

The aetiology of macromastia is usually undetermined, however, hormonal excesses and hypersensitivity of the target organ have been found in some cases. Cases of hyperprolactinaemia has been reported by some workers. Immunological risk factors for development of macromastia have also been seen in some groups of patients with Myasthenia gravis, Chronic arthritis, and Hashimoto thyroiditis. Ultrasonography may show no breast parenchyma abnormalities, while mammography may be indicated in some patients who are 40 years or older. Hormonal assay can be done but its value in treatment is doubtful. Drugs are only marginally effective in reversing gigantomastia, therefore surgery remains the mainstay of treatment.

Management of macromastia can be physically, socially and psychologically satisfying to both the patients and the surgeons.