title: Failure of bromocriptine therapy to control juvenile mammary hypertrophy.
abstract: Rapid massive breast hypertrophy occasionally occurs at the time of puberty or during pregnancy, with breast size eventually becoming burdensome or incapacitating to the patient. Pregnancy-related breast hypertrophy is often arrested or reversed by reducing serum prolactin levels with bromocriptine therapy. Unfortunately, breast enlargement in our 12-year-old patient with massive juvenile mammary hypertrophy was unaffected by bromocriptine therapy despite a reduction of her prolactin to normal levels. Two reduction mammaplasties followed by subcutaneous mastectomy were required to control breast hypertrophy. Breast-tissue hypersensitivity to prolactin appears to be a characteristic of pregnancy-related gigantomastia. Our pubertal patient with juvenile mammary hypertrophy failed to respond to bromocriptine therapy, so the aetiology of this syndrome may involve breast-tissue hypersensitivity to hormones other than prolactin.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, Maricopa Medical Center, Phoenix, Arizona, USA.
authors.forename: G D
authors.initials: GD
authors.lastname: Arscott
authors.forename: H R
authors.initials: HR
authors.lastname: Craig
authors.forename: L
authors.initials: L
authors.lastname: Gabay
mesh_terms: D001940:Breast / Q000473:pathology*; D001971:Bromocriptine / Q000627:therapeutic use*; D002648:Child; D005260:Female; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006801:Humans; D006966:Hyperprolactinemia / Q000150:complications; D006984:Hypertrophy / Q000188:drug therapy / Q000601:surgery; D016462:Mammaplasty / Q000379:methods; D015414:Mastectomy, Subcutaneous; D011388:Prolactin / Q000037:antagonists & inhibitors*; D017211:Treatment Failure
chemical_list: D006727:Hormone Antagonists; D001971:Bromocriptine; D011388:Prolactin