Breast - nonmalignant
Pubertal (virginal) macromastia

Author: Belinda Lategan, M.D. (see Authors page)

Revised: 24 July 2017, last major update August 2014

Copyright: (c) 2002-2017,, Inc.

PubMed Search: Pubertal macromastia

Cite this page: Pubertal (virginal) macromastia. website. Accessed October 22nd, 2018.
Definition / general
  • Alternate terms:
    • Adolescent / juvenile macromastia / gigantomastia
  • Other forms of gigantomastia not specific to adolescence
    • Gravid macromastia
    • Penicillamine induced
  • Unclear
  • Genetic
    • Mammary digital nail syndrome - rare
      • Anonychia onychodystrophy with hypoplasia or absence of distal phalanges in males and females (Eur J Hum Genet 2010;18:662)
      • Juvenile hypertrophy of the breast in affected females
  • Not associated with increased estrogen receptor protein expression in stroma
Clinical features
  • Sudden diffuse enlargement over 1 - 2 years during adolescence (average 6 months)
  • No subsequent involution
Clinical images

Images hosted on other servers:

Adolescent macromastia

Virginal (juvenile) breast hypertrophy

Unilateral enlargement

Autoimmune related cases

Microscopic (histologic) description
  • Diagnosed based on clinical history and morphology
  • Resembles gynecomastia
    • Greatly increased stromal collagen and fat
    • Lobules may be reduced or poorly developed
    • Duct epithelial hyperplasia less common
    • Pseudoangiomatous stromal hyperplasia
Microscopic (histologic) images

Images hosted on PathOut server:

AFIP fig 11: 15 year old girl

Images hosted on other servers:

Dense fibrosis with severe lobular atrophy