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| Year | Clinical presentation | Unique laboratory/radiology findings | Sample: histology | Treatment and outcome |
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| Final diagnosis of benign gestational macromastia |
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1947 [2] | 18-year-old with rapidly enlarging, tender, and ulcerated breasts in 3 sequential pregnancies, progressing to sepsis in first pregnancy. | Low urinary steroid metabolites (pregnanediol, estrogen, and 17-ketosteroids). | Biopsy of breast and axillary lymph node: chronic breast abscess, lactating breast, and hyperplastic lymph node. | Estrogen therapy: clinical worsening. Testosterone therapy: no improvement. Antibiotic therapy for ulceration and sepsis. Spontaneous reduction postpartum. |
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1954 [2] | 20-year-old with bilateral breast enlargement and left breast pain, redness, swelling, and discharge in second pregnancy and unilateral nodular enlargement in third pregnancy. | Low urinary steroid metabolites (pregnanediol, estrogen, and 17-ketosteroids). | N/A | Norethindrone: no further growth during pregnancy with increased urinary estrogen excretion. Spontaneous reduction postpartum. |
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1965 [21] | 22-year-old G2 with a history of myasthenia gravis, fibrocystic change, and idiopathic breast enlargement status—after bilateral reduction mammoplasty, with bilateral breast enlargement and skin thinning during the first trimester of pregnancy. | None. | Mastectomy tissue: fibroadenomatosis with extensive adenosis and proliferation of glandular elements, dilated ducts, and increased vascularization. | Bilateral subcutaneous mastectomy. |
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1986 [42] | 32-year-old G5 at 21 weeks, with bilateral breast enlargement, skin ulceration, severe pain, and difficulty ambulating. | None. | Mammoplasty tissue: proliferation of intermediate-sized ducts with atypical lobules, variable stromal fibrosis, edema, and focal fat necrosis without atypia. | Bilateral reduction mammoplasty. Postpartum bromocriptine 2.5 mg twice daily × 14 days: no signs of breast enlargement. |
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| 1987 [32] | 28-year-old G3 at 19 weeks with history of multiple bilateral fibroadenomas, with bilateral breast enlargement, local tenderness, backache, and bilateral axillary breast tissue. | None. | Mastectomy tissue: extensive collagenous stroma with atrophic lobules. | Symptomatic relief with bromocriptine (2.5 mg twice daily), partial regression with injectable medroxyprogesterone acetate. Eventual bilateral total mastectomy. |
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1988 [43] | 34-year-old gravid woman at 8-week GA with history of fibroadenomas, with bilateral breast enlargement, erythema, localized numbness, enlarged veins, and eventual tissue necrosis. | None. | Mastectomy tissue: multiple fibroadenomas with hyperplasia and multiple lactating adenomas. | Reductive mastectomy: no recurrence with subsequent pregnancies. |
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| 1995 [41] | 30-year-old G3 at 12 weeks with bilateral breast enlargement and limitation of daily activities, progressing to skin atrophy, infection, severe pain, and difficulty breathing. | None. | Fine-needle biopsy: cellular hypertrophy with no evidence of malignancy.
Mammoplasty tissue: lobular hyperplasia, connective tissue edema, and distension of secretory ducts. | Refractory to tamoxifen and furosemide therapy. Antibiotics for skin infection. Eventual postpartum reduction mammoplasty with no recurrence. |
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| 2002 [31] | 24-year-old G2 at 19 weeks with bilateral, rapidly enlarging breasts, pain, and difficulty with daily activities; with eventual ulceration. | None. | FNA: benign ductal cell hyperplasia with normal lobular structure. | Rest, dressings, antibiotics, progesterone, and furosemide: continued growth and edema. Elective cesarean at 34 weeks, bromocriptine therapy: reduction in breast size with eventual mammoplasty. |
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2003 [6] | 24-year-old G2 with bilateral, rapidly enlarging breasts, pain, difficulty breathing and eventual skin atrophy, venous engorgement, ulceration, necrosis, and hemorrhage. | None (all labs within normal limits). | Mastectomy tissue: lobular hyperplasia, dilated ducts, pseudoangiomatous hyperplasia, interstitial edema, and increased fat and connective tissue. | Bilateral simple mastectomy: no regrowth. |
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| 2004 [13] | 28-year-old with gradual, left-sided breast enlargement throughout pregnancy, presenting postpartum with persistent painful breast enlargement. | Fine-needle aspiration diagnosis of phyllodes tumor. | Mastectomy tissue: lactational changes, adenosis, and periductal and diffuse fibrosis. No features of phyllodes tumor or carcinoma. | Simple mastectomy, no recurrence at one-year follow-up. |
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| 2005 [12] | 23-year-old with unilateral breast enlargement persisting beyond delivery. | Tumor markers: increased CA19-9.
Ultrasound: homogenous mass with hypoechoic dilation of ducts.
Immunohistochemistry stain: CA19-9 positive. | Mammoplasty tissue: abundant proliferation of stromal loose connective tissue interposed with fat cells surrounding normal and lactating lobules. | Elective tumorectomy and mammoplasty. |
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2007 [48] | 23-year-old G2 at 12 weeks with bilateral breast enlargement, serous nipple discharge, hyperpigmentation, venous dilation, ulceration, and axillary lymphadenopathy. | Excisional biopsy: 20% epithelial cells with moderate ER and PR positivity. | Excisional biopsy of breast tissue and axillary lymph node: adenosis, moderate epitheliosis, fibrosis, and stromal B-lymphocytic infiltration. | Refractory to conservative management with NSAIDs, diuretics, and analgesics. Refractory to bromocriptine therapy. Eventual bilateral subcutaneous mastectomy with flap repair, without recurrence. |
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2008 [19] | 30-year-old G2 with twin pregnancy and history of myasthenia gravis, with bilateral breast enlargement, mastalgia, back pain, difficulty breathing, decreased range of motion, and insomnia from onset of pregnancy. | None. | Mastectomy tissue: dense lobular units containing dilated acinar units filled with eosinophilic proteinaceous material, separated by loose connective tissue, with collagen-fiber stroma and lymphocytic infiltration. | Bilateral reduction mammoplasty followed by bromocriptine therapy. |
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| 2011 [7] | 24-year-old G3 with bilateral breast swelling, milky discharge, pain, bilateral axillary lymphadenopathy, and limited range of motion of upper body. | Leukocytosis. | N/A | Conservative management with antibiotics, daily dressings and analgesics: spontaneous reduction postpartum. |
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| 2015 [37] | 27-year-old at 30 weeks with a history of joint inflammation and morning stiffness before pregnancy, and bilateral breast enlargement, pain, and axillary breast tissue growth since early pregnancy. | Anemia of chronic disease, positive ANA titer, positive APA titer, and hypocomplementemia. | Biopsy of breast tissue: sclerosing adenosis with usual hyperplasia. | Refractory to bromocriptine therapy. Postpartum bilateral mastectomy with excision of accessory glands: no recurrence. |
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| 2015 [49] | 32-year-old G5 at 33 weeks with history of bilateral breast enlargement in all previous pregnancies, with bilateral breast enlargement, back and neck discomfort, limitation of movement, erythematous skin, and dilated veins. | None. | Histology reported consistent with normal breast tissue. | Conservative management. Complete resolution postpartum. |
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| Final diagnosis of malignancy |
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1998 [45] | 26-year-old G2 with twin gestation at 28 weeks, with bilateral, rapidly enlarging breasts, headache, diplopia, and jaw pain. | Elevated LDH.
CT: nodal masses in left axilla, liver, bilateral kidneys, and retroperitoneum.
MRI of the head with contrast: prominent meningeal enhancement with possible lymphomatous involvement. | Nodule in labium majus found during episiotomy repair: dermal infiltration with high-grade, small, noncleaved cell lymphoma. | Preterm induction of labor due to elevated LDH. Postpartum systemic chemotherapy, radiation therapy, intrathecal methotrexate, and bone marrow transplant: death 9 months after diagnosis. |
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| 2005 [46] | 29-year-old with twin gestation at 33 weeks, bilateral breast enlargement, and dilated superficial veins. Postpartum development of shortness of breath. | Ultrasound: large hyporeflective nodes in both breasts with hypervascularization and fibrosis
MRI: large solid-tissue mass in upper anterior mediastinum. | Biopsy of mediastinal mass and right breast: diffuse lymphoid infiltration. Immunohistochemical analysis: T-cell lymphoblastic lymphoma. | Cesarean delivery at 33.4 weeks due to preterm labor. Refractory to postpartum bromocriptine, cabergoline, and erythromycin.
Follow-up with combination chemotherapy × 12 months. No further evidence of disease. |
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