The following is a summary of “Enlarged Breast Size (Macromastia) and Associated Neurologic Risks: A Scoping Review,” published in the July 2024 issue of Neurology by Pocock et al.
Many women with enlarged breasts (macromastia) experience headaches, and surgery to reduce breast size (reduction mammoplasty) often leads to headache improvement.
Researchers conducted a retrospective study to investigate the historical data on headaches in women with enlarged breasts (macromastia) and any connection to breast reduction surgery.
They conducted a literature search in PubMed Medline using concepts like “breast hypertrophy,” “macromastia,” “headache,” “migraine,” “breast reduction,” and “reduction mammoplasty” without limiting age, language, publication date, or study type. Supplemental searches were also performed to understand the potential mechanisms underlying macromastia-related headaches.
The results showed 25 studies describing macromastia-associated headache in the setting of reduction mammoplasty, comprising 23 original research studies (retrospective, n = 12, prospective, n = 11) totaling 3,799 patients, 1 systematic review, and 1 meta-analysis. Most (24/25) were published in plastic surgery, one in internal medicine, and none in neurology. The studies identified wide ranges for preoperative headache prevalence (2%–89%) and postoperative headache improvement (34%–100%). Headache types were categorized as “myofascial” or “tension-type” without specifying definitions, chronicity, headache screening method, or neurologic examination. Potential pathophysiologic mechanisms of macromastia-associated headache include structural, mechanical, psychosocial, and hormonal factors.
Investigators found no existing study in the Journal of Neurology on headaches linked to enlarged breasts (macromastia) and breast reduction surgery, highlighting a gap in women’s health knowledge outside of plastic surgery.