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Classification and external resources

Durston, a physician in 1670, drew this image of a patient suffering from non-gravid gigantomastia. She died as a result of the disease.
ICD-10 N62.
ICD-9 611.1
DiseasesDB 1628

Hypertrophy of breast, Gigantomastia or macromastia is extreme growth of the breasts (i.e. 10 pounds or more per breast). Also known as macromastia, it is the bilateral, benign progressive enlargement of the human breasts. Gigantomastia was first described in scientific literature in 1648.[1] The condition may be caused by heightened sensitivity to the female hormones prolactin, estrogen and progesterone, and/or the presence of an unusually high quantity of these hormones in the woman's bloodstream. Studies appear to show an abnormal reaction of the breast tissue to hormonal factors.[2] In severe cases, the breasts of women with this disorder can weigh in excess of 20 pounds (9.1 kg) each. The largest recorded weight was 67 pounds (30 kg) per breast.


Reported instances

Gigantomastia occurs in 1 out of every 28,000 to 100,000 pregnancies.[3] It can also affect men, although very rarely. An early case study dates to 1670. The patient died four months after the onset of enlargement. One breast removed after the woman's death weighed 64 pounds (29 kg).[4]

In 2005, a woman reported that at puberty her breasts grew from nothing to a C cup in one month. When she became pregnant for the first time, her breasts increased two cup sizes in a few days. Immediately after her first birth, her breasts grew three cup sizes. After her second child was born, her breasts increased six cup sizes. After her third childbirth, they grew 10 cup sizes, and after her fourth child was born, they grew nine cup sizes. In this instance, the swelling abated about 10 days after childbirth, but her bra cup size remained E to a G for the next year. About one year postpartum, her breasts rapidly atrophied to AA cup size.[5]

Another extreme case was observed in 2008 in Maria Vittoria Hospital in Turin, Italy where the amount removed from both breasts was 38 kilograms (84 lb). The growth occurred during puberty making it a case of juvenile gigantomastia, but the patient did not seek treatment until the age of 29.[6] Another extreme case was observed on August 28, 2003 when a 24 year old woman was admitted to the Clinical Center Skopje in Macedonia with gigantomastia of pregnancy and the amount later removed from both breasts was 33 kilograms (73 lb) total.[7][8] A second case in Macedonia was reported when the breasts of a 30-year-old woman from a remote mountain village in eastern Macedonia suddenly grew to more than 30 kilograms (66 lb) total.[8]

Virginal breast hypertrophy

When gigantomastia occurs in young women during puberty, the medical condition is known as juvenile macromastia and juvenile gigantomastia. Along with the excessive breast size, other symptoms include red, itchy lesions and pain in the breasts. A diagnosis is made when an adolescent's breasts grow rapidly and achieve great weight soon after the her first menstrual period. Some doctors suggest that breast development (thelarche) occurs before menstrual onset (menarche).[9]

Some women with VBH experience breast growth at a constant rate for several years, but the breasts rapidly develop exceeding normal growth. Some adolescent females experience minimal or negligible breast growth until their breasts suddenly grow very rapidly in a short period of time. This causes great physical discomfort.[citation needed] Women suffering VBH often experience an excessive growth of their nipples. In severe cases of VBH, hypertrophy of the clitoris occurs.[citation needed]

Causes and effects

The underlying cause of the rapidly growing breast connective tissue, resulting in gigantic proportions, is thought to be a heightened sensitivity to female hormones prolactin, estrogen and progesterone. At the onset of puberty, some females with who have experienced little or no breast development can grow three or more cup sizes within a few days.[5] This same effect can also occur at the onset of pregnancy or between the 16th to 20th week of gestation. When the swelling in the connective tissue occurs after birth, it can negatively impact long term milk supply.[5] The swelling increases with each subsequent pregnancy.

The extremely rapid growth of the breasts can result in intense heat. The woman's breasts can generate extraordinary discomfort, turning feverish, red, itchy, and even causing the skin to peel. The swelling can suppress the milk supply, pinching off the milk ducts, and leading to mastitis.[5]

Medical treatment

Medical treatment has not proven consistently effective. Medical regimens have included tamoxifen, progesterone, bromocriptine, and testosterone. Surgical therapy includes reduction mammaplasty and mastectomy.[10] However, breast reduction is not clinically indicated unless at least 4 pounds (1.8 kg) of tissue per breast needs to be removed.[11] In the majority of cases of macromastia, surgery is medically unnecessary, depending on body height. Topical treatment includes regimens of ice to cool the breasts.[5]

Social considerations

Extremely large breasts are a source of considerable attention. Some women try to hide or mask their breasts with special clothing, including minimizing brassieres. Finding large bra sizes and styles that fit is challenging. Ill-fitting bras with narrow straps can cause chronic irritation, redness, and indentations in the shoulders. Skin rashes under the breasts are common, particularly during warm weather. Heavy breasts may cause headaches, neck pain, upper and lower back pain, and numbness or tingling in the fingers.


  • Gigantomastia La Leche League, International
  • Swelstad MR, Swelstad BB, Rao VK, Gutowski KA. Management of gestational gigantomastia. Plast Reconstr Surg. 2006 Sep 15;118(4):840-8. Review. PMID 16980844
  • Baker SB, Burkey BA, Thornton P, LaRossa D. Juvenile gigantomastia: presentation of four cases and review of the literature. Ann Plast Surg. 2001 May;46(5):517-25; discussion 525-6. PMID 11352426


  1. ^ Palmuth, T (1648). Observations medicuarum centinae tres posthumae. Cent II. Braunschweig. 
  2. ^ Ohlsén, L.; O. Ericsson and M. Beausang-Linder (November, 1996). "Rapid, massive and unphysiological breast enlargement". European Journal of Plastic Surgery (Heidelberg: Springer Berlin) 9 (6). ISSN 0930-343X. 
  3. ^ Juan, Ph.D., Stephen. "Is it true that a woman's breasts can grow enormously overnight?". The Register U.K.. Retrieved 2009-09-12. 
  4. ^ Durston, W (1670). "Concerning the Death of the Bigg-breasted Woman". Philosophical Transactions (Royal Society of London) (1068). doi:10.1098. 
  5. ^ a b c d e Casciola, Cheri (June-July 2005). "Gigantomastia". Leaven (Chandler, Arizona) 41 (3): 62-63. Retrieved October 26, 2009. 
  6. ^ "A 38kg skin-reducing bilateral masectomy: a unique case". 
  7. ^ "A dramatic case in a Macedonian woman". 
  8. ^ a b "Macedonia faces 'giant' breast problem". 
  9. ^ "Puberty Stages of Development". Ask the Expert FAQs. Retrieved 2006-11-21. 
  10. ^ Bloom, MD, Sara A.; Maurice Y. Nahabedian, MD, FACS. "Gestational Macromastia: A Medical and Surgical Challenge". The Breast Journal (Washington, District of Columbia: Department of Plastic Surgery, Georgetown University) 11 (5): 492 - 495. doi:10.1111/j.1524-4741.2008.00628.x. Retrieved October 26, 2009. 
  11. ^ Kulkarni, Dhananjay; N. Beechey-Newman, H. Hamed and I.S. Fentiman (February 2006). Gigantomastia: A problem of local recurrence. The Breast. pp. 100-102. 

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