Reconstruction mammaire après gigantomastie gestationnelle : à propos d’un cas exceptionnel

The Place of Reductive Surgery in the Management of Gestational Ulcerative Gigantomastia: A Case Report at Sourô Sanou Teaching Hospital

“…Gestational gigantomastia is defined as one-sided hypertrophic mammary pathology [8] or most often bilateral, associated with rapid and monstrous epithelial hyperplasia during pregnancy [2–7, 10]. Another definition concerns the quantity of the mammary gland, where more than 1500 grams of breast tissues must be removed [1].…”

“…This is done by minimal morphological investigations, e.g., ultrasound scan or MRI of the breast, and eventually by an incisional biopsy of the lesions or fine needle aspiration biopsy guided by USS result [8]. Except local treatment to avoid superimposed infections, antalgic, and psychotherapy assistance, specific treatment of this gestational gigantomastia remains controversial [2, 3, 4, 6, 7, 13–15]. Medical treatment with bromocriptine has unanimously proved to be inefficient.…”

“…Surgery remains the main efficient treatment of this pathology [2, 3, 15]. Surgical modalities seem to find a consensus when it is a gravid gigantomastia in aged multipara who do not desire for more future pregnancy [7]. Reductive surgery is the rule when it is possible to insure good aesthetic result [6, 14], except when the patient prefers bilateral mastectomy with prosthetic or autologous reconstruction [11]; however, in case of a pauciparous young woman who may desire future pregnancy, the choice between reductive surgery and bilateral mastectomy becomes difficult.…”

“…Reductive surgery is the rule when it is possible to insure good aesthetic result [6, 14], except when the patient prefers bilateral mastectomy with prosthetic or autologous reconstruction [11]; however, in case of a pauciparous young woman who may desire future pregnancy, the choice between reductive surgery and bilateral mastectomy becomes difficult. The last impose an immediate [7] or differed [11] reconstruction according to the local conditions. However, reductive surgery exposes to risk of recurrence in some rare cases that have been described [5].…”

“…The authors are unanimous on the local care to be brought about the cutaneous ulceration and the inefficiency of the hormonal medical treatment [2, 3]. For this benign disease, the option between radical surgery with immediate reconstruction or differed reconstruction protecting against potential recurrence [7] and mammary reduction surgery exposed to recurrence is a scientific debate [2, 5].…”