The impact of macromastia on adolescents: a cross-sectional study.
OBJECTIVE
To determine the physical and psychosocial impact of macromastia on adolescents considering reduction mammaplasty in comparison with healthy adolescents.


METHODS
The following surveys were administered to adolescents with macromastia and control subjects, aged 12 to 21 years: Short-Form 36v2, Rosenberg Self-Esteem Scale, Breast-Related Symptoms Questionnaire, and Eating-Attitudes Test-26 (EAT-26). Demographic variables and self-reported breast symptoms were compared between the 2 groups. Linear regression models, unadjusted and adjusted for BMI category (normal weight, overweight, obese), were fit to determine the effect of case status on survey score. Odds ratios for the risk of disordered eating behaviors (EAT-26 score ≥ 20) in cases versus controls were also determined.


RESULTS
Ninety-six subjects with macromastia and 103 control subjects participated in this study. Age was similar between groups, but subjects with macromastia had a higher BMI (P = .02). Adolescents with macromastia had lower Short-Form 36v2 domain, Rosenberg Self-Esteem Scale, and Breast-Related Symptoms Questionnaire scores and higher EAT-26 scores compared with controls. Macromastia was also associated with a higher risk of disordered eating behaviors. In almost all cases, the impact of macromastia was independent of BMI category.


CONCLUSIONS
Macromastia has a substantial negative impact on health-related quality of life, self-esteem, physical symptoms, and eating behaviors in adolescents with this condition. These observations were largely independent of BMI category. Health care providers should be aware of these important negative health outcomes that are associated with macromastia and consider early evaluation for adolescents with this condition.
Adolescent Breast Clinic, Children's Hospital Boston, 300 Longwood Ave, Boston, MA 02115, USA.
Felecia
F
Cerrato
Michelle L
ML
Webb
Heather
H
Rosen
Laura
L
Nuzzi
Erika R
ER
McCarty
Amy D
AD
DiVasta
Arin K
AK
Greene
Brian I
BI
Labow
D000293:Adolescent; D015992:Body Mass Index; D001940:Breast / Q000002:abnormalities / Q000601:surgery; D002648:Child; D003430:Cross-Sectional Studies; D061345:Early Medical Intervention; D001068:Feeding and Eating Disorders / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000453:epidemiology / Q000523:psychology* / Q000601:surgery; D016462:Mammaplasty; D050177:Overweight / Q000453:epidemiology / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D012307:Risk Factors; D012649:Self Concept; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D055815:Young Adult