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Gestational Gigantomastia Patients Can Delay Surgery

But many eventually have breast reduction or mastectomy during pregnancy

THURSDAY, Sept. 28 (HealthDay News) -- Physicians can help gestational gigantomastia patients avoid surgery during pregnancy, but more than one-third eventually undergo breast reduction or mastectomy during pregnancy, researchers report in the Sept. 15 issue of Plastic and Reconstructive Surgery.

Matthew R. Swelstad, M.D., of the University of Wisconsin Medical School in Madison, and colleagues reviewed 23 gestational gigantomastia cases since 1968, including a patient who had double mastectomies after non-surgical treatment failed. The rare condition is characterized by breast enlargement leading to necrosis, ulcers and infection.

The researchers report that the patient had successful mastectomies, delivery and breast reconstruction. Medical attention helped 39 percent of patients avoid surgery during pregnancy, but 35 percent had breast reduction or mastectomy during pregnancy.

Among four patients who became pregnant after breast reduction surgery, two had mastectomy, one had surgically removed recurrences, and another was symptom-free during two pregnancies.

"Medical therapies to manage gestational gigantomastia are inconsistent in outcome," the authors write. "Since some patients respond, these therapies are worth trying. However, if the patient and/or fetus are experiencing significant morbidity, then surgical intervention is warranted. Breast reduction or mastectomy with delayed reconstruction is the preferred procedure. If the mother is considering future pregnancies, mastectomy offers the lowest risk of recurrence."

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