Management of Gestational Gigantomastia

Gestational gigantomastia is a rare condition characterised by rapid and excessive breast enlargement during pregnancy, which may lead to significant physical discomfort, psychosocial distress and potential obstetric complications. The management requires a multidisciplinary approach involving obstetricians, endocrinologists, plastic surgeons and mental health professionals. Initial evaluation includes comprehensive hormonal profiling and imaging to exclude differential diagnoses such as phyllodes tumours or malignancy. Conservative measures encompass analgesia, supportive garments and pharmacotherapy with dopamine agonists such as bromocriptine to mitigate prolactin‐mediated hypertrophy. When medical therapy proves insufficient or complications arise – including ulceration, necrosis or haemorrhage – surgical intervention is considered. Options range from reduction mammoplasty aimed at preserving breast tissue to total mastectomy with delayed reconstruction in severe or recurrent cases. Advances in reconstructive techniques have expanded the repertoire of procedures that balance maternal well‐being, aesthetic outcomes and future lactational potential. Management plans must also factor in the timing of delivery, as premature or induced labour may be indicated to alleviate maternal risk, followed by definitive surgical care in the postpartum period. Tight follow‐up is essential, given the risk of recurrence in subsequent pregnancies and the potential need for long‐term endocrine support.

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Management of Gestational Gigantomastia publication trend

The graph below shows the total number of articles in management of gestational gigantomastia across all publications each year (not limited to Nature Index journals).

Technical terms

Gestational gigantomastia: A rare pregnancy‐associated disorder marked by excessive bilateral breast enlargement.

Bromocriptine: A dopamine agonist used off‐label to reduce prolactin levels and mitigate breast hypertrophy.

Reduction mammoplasty: Surgical procedure to remove excess breast tissue and skin for size reduction and contouring.

Goldilocks procedure: A reconstructive technique utilising preserved skin flaps from post‐mastectomy tissue to form a breast mound without implants.

References

1. Gestational Gigantomastia Complicating Pregnancy: A Case Report and Review of the Literature. Case Reports in Obstetrics and Gynecology (2015).
2. Management of Gestational Gigantomastia with Goldilocks Procedure after Mastectomy: A Case Report and Review of Literature. Archives of Plastic Surgery (2024).
3. The Place of Reductive Surgery in the Management of Gestational Ulcerative Gigantomastia: A Case Report at Sourô Sanou Teaching Hospital. Case Reports in Surgery (2019).
4. Gestational gigantomastia—a rare entity complicated by life-threatening haemorrhage. Journal of Surgical Case Reports (2021).