Gigantomastia – a classification and review of the literature

Introduction: Gigantomastia is a rare, psychologically and physically disabling condition characterised by excessive breast growth. To date, there is no universal classification or accepted definition for this condition. Many authors cite gigantomastia as breast enlargement that requires reduction of over 1500 g per breast. However, there is discordance in the literature with the weight of reduction ranging from 0.8 to 2 kg, or even a D cup bra size. Practically this is a postoperative definition which is of little use to the clinician in terms of patient management or prognosis. Method: We conducted a literature review and meta analysis of all published cases of gigantomastia. We combined this with seven cases managed at Selly Oak Hospital, Birmingham, to give us a series of 115 patients. In order to devise a universally accepted definition of gigantomastia, a survey of 150 plastic surgery consultants within Europe was conducted. Participants were e-mailed a questionnaire, requesting their definition of gigantomastia with an appropriate excision weight. They were also asked to comment on any preoperative measurements taken to establish this predicted weight. Conclusion: We propose a classification of gigantomastia based on the cause, management and prognosis of the disease.