Mammoplasia

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Mammoplasia
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Mammoplasia is the normal or spontaneous enlargement of human breasts.[1] Mammoplasia occurs normally during puberty and pregnancy in women, as well as during certain periods of the menstrual cycle.[2][3][4] When it occurs in males, it is called gynecomastia and is considered to be pathological.[4] When it occurs in females and is extremely excessive, it is called macromastia (also known as gigantomastia or breast hypertrophy) and is similarly considered to be pathological.[5][6][7] Mammoplasia may be due to breast engorgement, which is temporary enlargement of the breasts caused by the production and storage of breast milk in association with lactation and/or galactorrhea (excessive or inappropriate production of milk).[8] Mastodynia (breast tenderness/pain) frequently co-occurs with mammoplasia.[9][10]

During the luteal phase (latter half) of the menstrual cycle, due to increased mammary blood flow and/or premenstrual fluid retention caused by high circulating concentrations of estrogen and/or progesterone, the breasts temporarily increase in size, and this is experienced by women as fullness, heaviness, swollenness, and a tingling sensation.[11][12]

Mammoplasia can be an effect or side effect of various drugs, including estrogens,[2][13] antiandrogens such as spironolactone,[14] cyproterone acetate,[15] bicalutamide,[16][17] and finasteride,[18][19] growth hormone,[20][21] and drugs that elevate prolactin levels such as D2 receptor antagonists like antipsychotics (e.g., risperidone), metoclopramide, and domperidone[22][23] and certain antidepressants like selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs).[23][24][25] The risk appears to be less with serotonin-norepinephrine reuptake inhibitors (SNRIs) like venlafaxine.[26] The "atypical" antidepressants mirtazapine and bupropion do not increase prolactin levels (bupropion may actually decrease prolactin levels), and hence there may be no risk with these agents.[22] Other drugs that have been associated with mammoplasia include D-penicillamine, bucillamine, neothetazone, ciclosporin, indinavir, marijuana, and cimetidine.[6][27]

A 1997 study found an association between the SSRIs and mammoplasia in 23 (39%) of its 59 female participants.[26] Studies have also found associations between SSRIs and galactorrhea.[24][28][29][30] These side effects seem to be due to hyperprolactinemia (elevated prolactin levels) induced by these drugs, an effect that appears to be caused by serotonin-mediated inhibition of tuberoinfundibular dopaminergic neurons that inhibit prolactin secretion.[26][28][29] It is noteworthy that the mammoplasia these drugs can cause has been found to be highly correlated with concomitant weight gain (in the 1997 study, 83% of those who experienced weight gain also experienced mammoplasia, while only 30% of those who did not experience weight gain experienced mammoplasia).[26] The mammoplasia associated with SSRIs is reported to be reversible with drug discontinuation.[30] SSRIs have notably been associated with a modestly increased risk of breast cancer.[31] This is in accordance with higher prolactin levels being associated with increased breast cancer risk.[32][33]

In puberty induction in hypogonadal girls and in feminizing hormone therapy in transgender women, as well as hormonal breast enhancement in women with breast hypoplasia or small breasts, mammoplasia is a desired effect.[34][35][36][37]

See also[edit | edit source]

References[edit | edit source]

  1. ↑ , Present Concepts of Benign Breast Disease, New England Journal of Medicine, 1946, Vol. 235(Issue: 15), pp. 548–553, DOI: 10.1056/NEJM194610102351505,
  2. ↑ 2.0 2.1 , Management of Breast Diseases. online version, Springer Science & Business Media, ISBN 978-3-540-69743-5, Pages: 21–,
  3. ↑ , Progress in Obstetrics and Gynecology--3. online version, Jaypee Brothers Medical Publishers Pvt. Ltd., ISBN 978-93-5090-575-3, Pages: 393–394,
  4. ↑ 4.0 4.1 , Pediatric Endocrinology: Mechanisms, Manifestations, and Management. online version, Lippincott Williams & Wilkins, 2004, ISBN 978-0-7817-4059-3, Pages: 349–,
  5. ↑ , Pediatric Surgery. online version, Elsevier Health Sciences, ISBN 978-0-323-09161-9, Pages: 773–,
  6. ↑ 6.0 6.1 {{{last}}}, David J. Dabbs, Breast Pathology. online version, Elsevier Health Sciences, 2012, ISBN 978-1-4377-0604-8, Pages: 19–,
  7. ↑ , Pediatric and Adolescent Obstetrics and Gynecology. online version, Springer Science & Business Media, ISBN 978-1-4612-5064-7, Pages: 99–,
  8. ↑ , TEXTBOOK OF BIOCHEMISTRY AND HUMAN BIOLOGY. online version, PHI Learning Pvt. Ltd., ISBN 978-81-203-1965-3, Pages: 959–,
  9. ↑ {{{last}}}, Christoph Zink, Dictionary of Obstetrics and Gynecology. online version, Walter de Gruyter, ISBN 978-3-11-085727-6, Pages: 152–,
  10. ↑ , Radiotherapy for Non-Malignant Disorders. online version, Springer Science & Business Media, ISBN 978-3-540-68943-0, Pages: 719–,
  11. ↑ , Breastfeeding: A Guide for the Medical Profession. online version, Elsevier Health Sciences, ISBN 978-0-323-35776-0,
  12. ↑ , Changes in breast volume during normal menstrual cycle and after oral contraceptives, Br Med J, 1975, Vol. 4(Issue: 5995), pp. 494–6, DOI: 10.1136/bmj.4.5995.494, PMID: 1192144, PMC: 1675650,
  13. ↑ {{{last}}}, Robert Alan Lewis, Lewis' Dictionary of Toxicology. online version, CRC Press, ISBN 978-1-56670-223-2, Pages: 470–,
  14. ↑ {{{last}}}, Jeffrey K. Aronson, Meyler's Side Effects of Cardiovascular Drugs. online version, Elsevier, ISBN 978-0-08-093289-7, Pages: 255–,
  15. ↑ {{{last}}}, Elizabeth Martin, Concise Medical Dictionary. online version, Oxford University Press, ISBN 978-0-19-968781-7, Pages: 189–,
  16. ↑ , Dr. Patrick Walsh's Guide to Surviving Prostate Cancer, Second Edition. online version, Grand Central Publishing, ISBN 978-1-4555-0016-1, Pages: 258–,
  17. ↑ {{{last}}}, Harvey B. Simon, The Harvard Medical School Guide to Men's Health: Lessons from the Harvard Men's Health Studies. online version, Simon and Schuster, ISBN 978-0-684-87182-0, Pages: 403–,
  18. ↑ {{{last}}}, Jeffrey K. Aronson, Meyler's Side Effects of Endocrine and Metabolic Drugs. online version, Elsevier, ISBN 978-0-08-093292-7, Pages: 155–,
  19. ↑ , Lehne's Pharmacology for Nursing Care. online version, Elsevier Health Sciences, ISBN 978-0-323-34026-7, Pages: 802–,
  20. ↑ {{{last}}}, Sat Dharam Kaur, The Complete Natural Medicine Guide to Breast Cancer: A Practical Manual for Understanding, Prevention & Care. online version, R. Rose, 2003, ISBN 978-0-7788-0083-5,
  21. ↑ , Adverse effects of growth hormone replacement therapy in children, Arquivos Brasileiros de Endocrinologia & Metabologia, 2011, Vol. 55(Issue: 8), pp. 559–565, DOI: 10.1590/S0004-27302011000800009,
  22. ↑ 22.0 22.1 , Pharmacological causes of hyperprolactinemia, Ther Clin Risk Manag, 2007, Vol. 3(Issue: 5), pp. 929–51, PMID: 18473017, PMC: 2376090,
  23. ↑ 23.0 23.1 , Hyperprolactinemia associated with psychotropics-a review, Human Psychopharmacology: Clinical and Experimental, 2010, Vol. 25(Issue: 4), pp. 281–297, DOI: 10.1002/hup.1116, PMID: 20521318,
  24. ↑ 24.0 24.1 , Handbook of Psychiatric Drugs. online version, John Wiley & Sons, ISBN 978-0-470-02821-6, Pages: 75–,
  25. ↑ , Antidepressant-Selective Gynecomastia, Annals of Pharmacotherapy, 2013, Vol. 47(Issue: 1), pp. e6, DOI: 10.1345/aph.1R491, PMID: 23324513,
  26. ↑ 26.0 26.1 26.2 26.3 , Breast enlargement during chronic antidepressant therapy, J Affect Disord, 1997, Vol. 46(Issue: 2), pp. 151–6, DOI: 10.1016/s0165-0327(97)00086-4, PMID: 9479619,
  27. ↑ , Gigantomastia – a classification and review of the literature, Journal of Plastic, Reconstructive & Aesthetic Surgery, 2008, Vol. 61(Issue: 5), pp. 493–502, DOI: 10.1016/j.bjps.2007.10.041, PMID: 18054304,
  28. ↑ 28.0 28.1 , Antidepressant-induced hyperprolactinaemia: incidence, mechanisms and management, CNS Drugs, 2010, Vol. 24(Issue: 7), pp. 563–74, DOI: 10.2165/11533140-000000000-00000, PMID: 20527996,
  29. ↑ 29.0 29.1 , A new logical insight and putative mechanism behind fluoxetine-induced amenorrhea, hyperprolactinemia and galactorrhea in a case series, Therapeutic Advances in Psychopharmacology, 2013, Vol. 3(Issue: 6), pp. 322–334, DOI: 10.1177/2045125313490305, PMID: 24294485, PMC: 3840809,
  30. ↑ 30.0 30.1 {{{last}}}, Benjamin Sadock, Kaplan & Sadock's Pocket Handbook of Psychiatric Drug Treatment. online version, Lippincott Williams & Wilkins, ISBN 978-1-4698-5538-7, Pages: 312–,
  31. ↑ , Anti-depressant therapy and cancer risk: A nested case-control study, Eur Neuropsychopharmacol, 2015, Vol. 25(Issue: 8), pp. 1147–57, DOI: 10.1016/j.euroneuro.2015.04.010, PMID: 25934397,
  32. ↑ , Plasma Prolactin Levels and Subsequent Risk of Breast Cancer in Postmenopausal Women, JNCI Journal of the National Cancer Institute, 1999, Vol. 91(Issue: 7), pp. 629–634, DOI: 10.1093/jnci/91.7.629, PMID: 10203283,
  33. ↑ , Plasma Prolactin Concentrations and Risk of Postmenopausal Breast Cancer, Cancer Research, 2004, Vol. 64(Issue: 18), pp. 6814–6819, DOI: 10.1158/0008-5472.CAN-04-1870, PMID: 15375001,
  34. ↑ , Introduction and management of puberty in girls, Horm. Res., 2007, Vol. 68 Suppl 5(Issue: 5), pp. 80–3, DOI: 10.1159/000110584, PMID: 18174716,
  35. ↑ , Praktische Hormontherapie in der Gynäkologie. online version, Walter de Gruyter, ISBN 978-3-11-024568-4, Pages: 385–,
  36. ↑ , Metastasis of Breast Cancer. online version, Springer Science & Business Media, ISBN 978-1-4020-5866-0, Pages: 217–,
  37. ↑ , Hormonal breast augmentation: prognostic relevance of insulin-like growth factor-I, Gynecol. Endocrinol., 1998, Vol. 12(Issue: 2), pp. 123–7, DOI: 10.3109/09513599809024960, PMID: 9610425,

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Classification
External resources


  • Breast changes during pregnancy

  • Histology of lactating breast, annotated

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