Abstract
PurposeSymptomatic macromastia causes physical and psychological problems that can lead to restrictions in the patients’ social and working lives and a reduced quality of life. Associated medical treatments also have a considerable impact on health-care costs. Several studies have assessed these costs, but the total disease costs of macromastia have never been evaluated on the basis of real-world data.MethodsThe data for 76 patients who underwent reduction mammoplasty between 2008 and 2016 were collected using a two-part questionnaire (preoperative and postoperative), as well as the patient files. Topics surveyed, besides demographic data, included physician visits, medical imaging, medical procedures, medical treatments, rehabilitation and convalescent measures, drug intake, medical aids, exercise activity, and sick leave days before surgery, to calculate the costs per year of conservative treatment of symptomatic macromastia.ResultsThe mean time from start of symptoms to surgery was 11.82 years. The data for this group of patients with symptomatic macromastia show that costs per patient amount to €1677.55 per year. These costs include medical consultation, radiological imaging, medical treatments and procedures, physical therapy and rehabilitation, medication, special brassieres, exercise classes costs for sick leave due to problems with macromastia, and travel expenses.ConclusionsThese results show that considerable health-care costs arise due to macromastia with conservative treatment. Overall, macromastia costs €1677.55 per patient/year. In particular, lost productivity due to sick days and the costs of physiotherapy are factors driving the high costs.
Highlights
There is no unique definition of macromastia
The patients were identified from the hospital information system using the operation and procedure (OPS) codes 5–884 ff. and ICD10 diagnosis N62
Contact with the family physician due to symptoms of macromastia was reported by 55.3% of the patients
Summary
There is no unique definition of macromastia. There are several different synonyms for it, such as gigantomastia and hyperplasia of the mammary gland. Macromastia is usually defined as excessive growth of the mammary gland beyond the normal range [1]. What is normal always lies in the eye of the beholder and may vary between countries and cultures, with fluid transitions along a continuum. Another definition is based on the symptoms: chronic pain in at least three anatomic regions, triggered by large breasts [2]. The precise cause of macromastia is still as yet unknown. As the definitions used are not standardized, there are no exact figures for the incidence
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