Surgery for giant tumours of the breast: a 15 year review

  • Mahendra Daya University of KwaZulu-Natal
  • Theogren Balakrishnan St Anne's Hospital
Keywords: Giant tumour breast reduction mammaplasty, giant fibroadenoma of breast, phyllodes tumour, hamartoma breast


Background: Giant tumours of the breast tend to occur in the adolescent age group. Racial predilection has been noted in the literature. The mass often occupies most of the breast, leading to its distortion. Many authors have advocated a mastectomy for benign tumours that severely distort the breast. Giant benign tumours when treated by simple excision risk persistence of asymmetry. To avoid this asymmetry, some authors have resorted to excision and immediate reduction mammaplasty. The aim of this retrospective study was a report on giant tumours of the breast presenting to a plastic surgery unit and to analyse demographic factors, clinical presentations, tumour pathology, management, complications, as well as patient and breast outcomes.

Methods: Medical records of patients with giant tumours were retrospectively analysed for assessing demographic factors, clinical presentation, tumour pathology, the technique of surgery performed and patient and breast outcomes in a single hospital setting. Breast outcomes were rated by panel of 4 experienced plastic surgeons using the 4 Point Likert scale. Their ratings were statistically analysed for inter-rater agreement.

Results: Twenty-three subjects were identified to have giant tumours of the breast. Of these South African patients, 19 were black, 3 were Indian and 1 was of mixed ethnicity. The age range was 12–49 years(y) with an average of 19y. All masses were palpable. The final pathological diagnosis was fibrocystic disease in 3, giant fibroadenoma in 14, phyllodes tumour in 4, and hamartoma in 2. The size range was 10–45 cm with a median size of 18 cm. All but one patient had simple excision followed by immediate reduction mammaplasty. Twenty patients were assessed after operation. A minimum of 1 to a maximum of 4 patients per reviewer showed unsatisfactory outcomes and a minimum of 18 to a maximum of 21 patients  per reviewer showed satisfactory to excellent outcomes. The overall agreement between assessors for this was 84%.

Conclusion: Benign giant tumours (>10 cm) of the breast are suitably managed by excision of the mass and a reduction mammoplasty technique of reconstruction.

Author Biographies

Mahendra Daya, University of KwaZulu-Natal

Department of Plastic and Reconstructive Surgery
Nelson R Mandela School of Medicine
Inkhosi Albert Luthuli Central Hospital
University of KwaZulu-Natal

Theogren Balakrishnan, St Anne's Hospital
Plastic and Reconstructive Surgeon in private practice
How to Cite
Daya, M., & Balakrishnan, T. (2018). Surgery for giant tumours of the breast: a 15 year review. South African Journal of Surgery, 56(3), 9-15. Retrieved from
General Surgery