New Delhi: A study published in the October issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons, found that combined oral contraceptives (COCs) containing both estrogen and progestin do not contribute to the development of enlarged breasts (macromastia). , nor do they increase the risk of breast redevelopment in adolescents and young women after breast-reduction surgery (ASPS). Walters Kluwer published the magazine as part of the Lippincott portfolio.
ASPS member surgeon Brian I. of Boston Children’s Hospital and Harvard Medical School and colleagues. According to new research by Labo, COC use during adolescence may actually be associated with less severe breast enlargement (hypertrophy). Doctors are recommended to test COCs for young women with macromastia.
Breast reduction surgery, also known as reduction mammoplasty, is an effective treatment for adolescents and women with macromastia to reduce pain and psychosocial issues. The most common type of hormonal contraception is combined oral contraceptives (HC). COCs are used to treat a variety of ailments in adolescents, including acne, menstrual irregularities, endometriosis, and polycystic ovary syndrome, in addition to their contraceptive benefits.
“Despite the favorable effects of COCs, many patients, parents and physicians are concerned that their use will increase breast hypertrophy in adolescents,” Dr. Lebow and colleagues wrote. They write, “The Internet is full of anecdotes suggesting that COC use in adolescents and young women may lead to breast enlargement.” “The Internet is replete with anecdotal accounts suggesting that COC use in adolescents and young women may lead to breast enlargement.”
What is the actual effect of COCs on breast growth and symptoms in young women and girls? The study included 378 patients between the ages of 12 and 21 who received reduction mammoplasty at Boston Children’s Hospital. The severity of macromastia was compared in patients who used COCs and other HCs, as well as breast enlargement in the first year after mammoplasty reduction.
The findings were compared to 378 female patients of similar age in a control group. In both groups, the mean age was about 18 years. Patients who had macromastia were more likely to be overweight or obese, which is consistent with the idea that obesity is a risk factor for macromastia.
Overall, patients with macromastia used less HC: approximately 38% versus 65% in the control group. On the other hand, women taking HCs with macromastia were more likely to be prescribed COCs: 83% vs 53%. Estrogen and progestin doses were comparable between groups. The use of COCs did not reduce the severity of breast enlargement in patients with macromastia. The average amount of breast tissue removed during breast tissue reduction was similar between groups—in fact, somewhat less in women using COCs than in those without HC use. Pain and other macromastia symptoms (such as burning breast skin, trouble exercising, or difficulty finding clothes that fit) were also similar between the groups.
There was no significant difference in the rate of breast regrowth between patients who used COCs and those who did not use COCs at a median follow-up of approximately 2 years after breast cancer reduction. Overall, approximately 5% of individuals experienced postoperative breast regrowth. About half of cases are due to re-enlargement of the mammary gland rather than weight gain. Women who took COCs after less mammoplasty also had no higher risk of breast engorgement.
According to Lebow and colleagues, the data serve to dispel the “wide anecdotal assertion” that COCs may increase the incidence of macromastia in adolescence. “Although more studies are needed,” they conclude, “providers are urged to consider COCs when prescribing HC for their patients with macromastia where necessary and appropriate.”