Objective. To develop the algorithm examination and treatment of patients with macromastia and diffuse breast dysplasia.

Material and methods. We analyzed postoperative outcomes in 105 patients with macromastia. Women underwent breast reduction alone or with simultaneous reconstruction by implants. Gynecologist-endocrinologist followed-up all patients for 4 years. Age of patients ranged from 22 to 55 years (mean 41.9±2.1), body mass index — 28-35 kg/m2. All patients underwent preoperative mammography and routine clinical examination to exclude breast cancer.

Results. Among 105 patients with macromastia, we found diffuse cystic mastopathy in 48 (45.7%) cases, fibroadenosis — 33 (31.4%), fibrosclerosis — 15 (14.2%), intraductal ectasia — 5 (2.9%), intraductal hyperplasia without atypia — 1 (2.9%), invasive ductal cancer in situ — 1 (2.9) case. Surgical intervention was determined individually. The following operations were performed depending on localization of lesion: breast reduction with subsequent reconstruction by autologous tissues — 84 (80%) patients, subtotal reduction and reconstruction by implants for partial involvement of glandular tissue — 15 (14.3%) patients, breast reduction using implants for total lesion — 6 (5.7%) cases.

Conclusion. Incidence of postoperative diagnosis of latent breast cancer after reduction mammoplasty is low, but it creates significant therapeutic problems. Thorough preoperative diagnosis is essential for patients with macromastia and benign breast dysplasia. In addition, routine histological analysis is also recommended.

Keywords. breast diseases, macromastia, benign breast dysplasia, dyshormonal macromastia, ductal carcinoma in situ (DCIS)