Query: Juvenile macromastia

title: Comparative study of ultrasonographical and pathological manifestations of juvenile macromastia
abstract: To expatiate the ultrasonographical and pathological manifestations of breasts with juvenile macromastia. Four patients with juvenile macromastia were examined by high frequency ultrasonography.The sonographical and pathological images were observed and reported. The sonographical characteristics of the breasts with juvenile macromastia were similar: the anatomical structures of the breasts were obscure,which were characterized by cystic formation,reticular structure,patched hypoechoic or hyperechoic regions and distorted gland structure.One patient had fibroadenoma and dermatic erythema.The results of pathological examination showed marked cystic proliferation of glands accompanied with ductal epithelial hyperplasia,irregular ductal distribution,no lobules formation or proliferation of fat tissue,fibrocyte and fibroblast. The abnormalities of juvenile macromastia may not only be the huge volume,but also may include abnormal ultrasonographical and pathological manifestations,awaiting more follow up studies.

title: [Syndrome of juvenile schizophrenia and macromastia; clinicopsychological study]

title: [Juvenile fibroadenomatosis associated with mastopathy and macromastia. Clinicopathologic and puncture biopsy cytologic relationships]

title: A Case Report of Juvenile Hypertrophy of the Breast in a 15 Year Old Girl: Presented with Asymmetric Breast Enlargement and a Focal Mass like Lesion
abstract: Juvenile (or virginal) hypertrophy of the breast is a rare condition, leading to hyperplastic breast anomalies (macromastia) in adolescents (1 3) In this condition, atypical, surprisingly rapid and continued breast growth, occurs during puberty (1) This enlargement may be unilateral or bilateral, and can occur any time during puberty (1 4) The term gigantomastia may be used to refer to cases of extreme breast enlargement (1, 4, 5) Rapid bilateral or unilateral breast growth in adolescent girls leads to severe physical and psychological problems (1 6) Imaging findings of juvenile hypertrophy of the breast have not been well described in previous reports. We report ultrasonography (US) and magnetic resonance imaging (MRI) findings, in a case of juvenile hypertrophy of the breast in a 15 year old girl, presented with asymmetric breast enlargement and a focal mass like lesion.

title: [Giant breast fibroadenomas in adolescents: Diagnostic and therapeutic procedures]
abstract: Breast masses are rare in girls and female adolescents, and they exceptionally have a malignant aetiology. The most frequent diagnosis in these masses is juvenile fibroadenoma. When its size exceeds 5 cm, it is called giant fibroadenoma (GFA) a large sized benign tumour with rapid growth. The differential diagnosis of GFA includes inflammatory processes, benign proliferative lesions and phyllodes tumour. Due to the lack of specific clinical guidelines for its correct diagnosis and treatment, the management of breast masses may pose difficulties. We conducted a retrospective study of the breast masses larger than 5 cm managed between 2000 and 2017 in a paediatric hospital. We collected data on the clinical characteristics and the diagnostic tests and treatment used in each case. The data was retrieved from the health records adhering to the protocols established by the hospital. We present 4 cases of macromastia in patients with a median age of 15.3 years (range, 11.9 16.2) at Tanner stage 5 of pubertal development that sought care after developing a unilateral breast mass that was painless and growing quickly. On physical examination, the masses were painless, mobile, unattached to deeper tissues and with hypervascularization at the skin level  None of the patients had nipple discharge or local lymphadenopathy. Sonographic examination of the breast revealed hypoechoic, lobulated masses with well defined margins, in cases 1 and 3 with superficial hypervascularization. The findings in all patients were compatible with GFA or phyllodes tumour. The assessment of cases 1 and 4 included an MRI

title: A 16 year follow up on a juvenile macromastic patient
abstract: The need for persons to undergo surgery becomes necessary in persons with breast hypertrophy This study was carried out on a patient with juvenile macromastia sixteen (16) years after surgical treatment at the Komfo Anokye Teaching Hospital in Kumasi, Ghana. The patient answered a questionnaire which included her pre and post surgery experience, her reproductive life, as well as improvement in psychological and physiological well being. After surgery, she no longer experienced any psychological complication; she now has a good self esteem and has developed a positive self image. However, physical examination showed a distortion in her left breast. Her quality of life encompassing her physiological and psychological experiences have positively improved after surgery and she is very satisfied with her current state even though there is an obvious deformity in her left breast.

title: Giant Fibroadenoma having Florid Adenomyoepithelial Adenosis with Microglandular Adenosis
abstract: Breast masses are uncommon in children and adolescent. Giant fibroadenoma account for 0.5% 2% of all fibroadenoma& (and the) exact etiology is not known. Fibroadenomas tend to grow slowly and often reach a maximum diameter of 2 3 cm in size. Among breast masses pathologic lesion such as giant fibroadenoma, phylloides tumor and virginal breast hypertrophy (juvenile macromastia) rapidly massively increase in size over a short time. We present a case of giant fibroadenoma having florid adenomyoepithelial adenosis with focal microglandular adenosis.

title: Measurement of Mammary Epithelial Cell Size in Juvenile Macromastic Breasts
abstract: Patients with macromastia not only suffer from physical discomforts but also psychosocial adjustment disorders and seek for surgical inter vention. Macromastia is divided into two groups, juvenile and gravid hypertrophy, according to the onset of excessive breast development. The cause of macromastia is not well understood and may be related to the mistakes in gene expression during puberty or pregnancy. There are a lot of researches focusing on the molecular mechanism of breast cancer and lactation, but seldom on macromastia. The size of an organ is determined by the size of the cells and the number of the cells, which depends on cell division and cell death. This study intended to investigate the difference between breast tissues from juvenile macromastia patients and non tumor invaded breast tissue taken from breast cancer patients, by analyzing mammary epithelial cell size. Patients who received reduction mammaplasty for juvenile macr omastia in NTUH from January 2003 to December 2005 are enrolled as macromastia group. The control group includes the patients who received breast operation for breast cancer in NTUH in the same time period, with breast sizes not larger than C cup. The exclusion criteria are age over 29 or less than 18, positive pregnancy history, irregular menstral cycle, body mass index over 27, hormone exposure within 3 months, and abnormal hormone level. Sections (5 mm) from formalinm fixed, paraffin embedded blocks were cut for each case, followed by hematoxylin eosin stain. The sections were used for measurement of mammary epithelial cell size. Nonparametric Wilcoxan rank sum test was used for comparison of data among the two groups. There were 8 patients in the macromastia group and 5 patients in the control one. Mammary epithelial cell size measurement showed no difference between the two groups (72.7+ 12.3 mm^2 vs. 69.5+ 10.0 mm^2, p=0.46) The study showed no difference between the juvenile macromastic breast and non tumor part of cancer breast in mammary epithelial cells, suggesting that the cause of juvenile macromastia may be from factors other than abnormal mammary epithelial cell size.

title: Juvenile gigantomastia, two cases treated by reduction mammoplasty with nipple areola complex graft
abstract: Gigantomastia or "Gravidic macromastia" is a rare benign disorder of the breast, in which the breasts undergo a massive hypertrophy and increase in size. It may occur during marked hormonal changes as in puberty or pregnancy or after prolonged intake of certain medicine. The condition is manifested as a massive diffuse enlargement of the breast. It is usually associated with psychological effect on the patient and her family and physical disability due to excessive breast growth. This rare condition is of undetermined aetiology, which may be due to excess hormonal secretion, or hypersensitivity of the target organ to normal hormonal level. Histologically it is a glandular hyperplasia with an increase in connective tissue. This paper reports two case of gigantomastia due to hormonal changes during puberty. Ulceration and haemorrhage of the breasts complicated the picture and is the main cause of coming to surgery. Surgical procedure was subtotal mastectomy and free implantation of the nipple

title: Florid Juvenile (Cellular) Fibroadenomatosis in the Adolescent: A Case for Subcutaneous Mastectomy?
abstract: Juvenile or giant fibroadenoma (JF) is an uncommon fibroadenoma variant usually presenting in adolescence. Although these masses are benign, when multiple and bilateral, they present a complex challenge to the attending surgeon, both in diagnosis, and in selection of the most appropriate therapy. Treatment is usually surgical and ranges from simple excision to subcutaneous mastectomy with reconstruction. We report an unusual case of refractory JF, initially treated with combined hormonal and surgical treatment but ultimately requiring bilateral subcutaneous mastectomies to prevent tumor regrowth. This case highlights the occasional difficulty in the management of macromastia in the adolescent female.