Women with enlarged breast tissue, known medically as macromastia, may be more likely to experience chronic migraine, neck pain, certain spinal nerve disorders and obstructive sleep apnea, according to a new study by Wake Forest University School of Medicine researchers, published Tuesday in the journal Headache.
The findings suggest enlarged breast tissue may affect more than physical comfort and could play a role in several health conditions that impact quality of life.
Researchers used a medical record database, examining electronic health records from 687 women treated between 2017 and 2024 at headache and neurology clinics affiliated with Stanford Medical Center. This included 347 women diagnosed with macromastia and 340 women without the condition. After accounting for factors such as age, body mass index, depression and anxiety, women with macromastia were significantly more likely to have chronic migraine, neck pain, obstructive sleep apnea and cervical radiculopathy, a condition caused by irritation or compression of nerves in the neck.
The study found that women with macromastia were about 40% more likely to have chronic migraine, twice as likely to experience neck pain, about 50% more likely to have obstructive sleep apnea and more than twice as likely to have cervical radiculopathy and compared with women without macromastia.
"Many people think of enlarged breast tissue primarily as a cosmetic issue, but our findings suggest it may be associated with a broader range of women’s health concerns, including chronic migraine, neck pain and sleep-related breathing disorders," said Kristyn Pocock, M.D., assistant professor of neurology at Wake Forest University School of Medicine and lead author of the study. "By better understanding these connections, we can help ensure women receive more comprehensive evaluations and care for symptoms that may affect their daily lives."
Patients often report symptoms related to macromastia like headaches, neck and back pain and shoulder discomfort, even seeking breast reduction surgery to relieve symptoms. But while headaches are often recognized by insurers as a symptom associated with macromastia, researchers say relatively little is known about how enlarged breast tissue may relate to specific headache disorders and other neurological conditions.
In the study, researchers also examined factors associated with breast reduction surgery among women with macromastia. They found that neck pain was the only condition linked to a significantly greater likelihood of undergoing breast reduction surgery.
Although the findings identified important associations, additional research is needed to determine the mechanisms through which macromastia influences migraine, neck pain or sleep apnea. Because the research was based on a review of existing medical records at a single point in time, additional studies could improve understanding of the relationship among these conditions and whether treating macromastia could improve symptoms.
"These findings raise important questions about how enlarged breast tissue may contribute to painful symptoms for women," Pocock said. "More research is needed to determine whether treating macromastia could help certain women find relief and enhance quality of life."
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About Wake Forest University School of Medicine
Wake Forest University School of Medicine is the academic core of Charlotte, North Carolina-based Advocate Health and a recognized leader in experiential medical education and groundbreaking research. It directs the education of nearly 1,900 students and fellows, including physicians, basic scientists and allied clinical professionals. The school of medicine also strategically investigates opportunities that will expand basic and clinical research, resulting in nationally and internationally recognized excellence in biomedical research. The school has two campuses, each co-located with leading-edge innovation districts, The Pearl, in Charlotte, and Innovation Quarter, in Winston-Salem, North Carolina. These affiliated life-sciences innovation districts focus on advancing health care through new medical technologies and biomedical discovery.
About Advocate Health
Headquartered in Charlotte, North Carolina, Advocate Health is the third-largest nonprofit, integrated health system in the United States. A preeminent academic health system at the forefront of clinical excellence, innovation and research, it delivers care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin and Michigan, and Wake Forest University School of Medicine is its academic core. Nationally recognized for expertise in heart and vascular, neurosciences, oncology, pediatrics and rehabilitation, Advocate Health is also a pioneer in the delivery of virtual health care. It is accelerating discovery by making research participation part of the standard-of-care through its one-of-a-kind National Center for Clinical Trials, plus two affiliated life-sciences-focused innovation districts and one of the nation’s largest graduate medical education programs. With more than 165,000 teammates serving patients at 69 hospitals and over 1,000 care locations across eight states, Advocate Health reinvests over $6 billion each year to improve community health, making it one of the nation’s largest providers of community benefit.