Researchers from the University of Toronto have documented a rare instance of gigantomastia—abnormal and excessive breast growth—following the administration of the Pfizer COVID-19 vaccine.
A 19-year-old woman, previously healthy with no notable medical history, experienced rapid breast enlargement just one week after receiving her first dose of the Pfizer COVID-19 vaccine in September 2022.
Her condition worsened following the second dose, with her breast size increasing dramatically from a B cup to a triple G over six months.
Social media users have dubbed this unusual case the “Pfizer Boob Job.”
Despite undergoing extensive medical evaluations, no hormonal abnormalities or other causes were identified.
Doctors determined that the woman’s symptoms aligned with pseudoangiomatous stromal hyperplasia (PASH), a rare condition involving idiopathic fibrous mammary tissue growth.
The association between PASH and vaccine administration has not been previously established, making this case particularly noteworthy.
According to the medical journal:
This case presents a healthy young woman with rapid bilateral breast enlargement 1 week following Pfizer COVID-19 vaccine administration. After ruling out other potential causes, she underwent bilateral reduction mammoplasty, with histology revealing dense terminal duct lobular units interspersed with PASH.
The patient believed that the vaccine caused her breast growth; however, her concerns were not adequately addressed by her primary care physicians, leading to mistrust in the healthcare system.
After multiple specialist consultations and unsuccessful medication trials, she underwent definitive surgical treatment. Although a temporal relationship does not establish causality, dismissing patient concerns can erode trust. Physicians should consider and value patient concerns when developing therapeutic relationships.
PASH-associated gigantomastia is rare, with fewer than 20 documented cases. Current gigantomastia classification systems do not account for PASH as an etiological factor and lack detail on the timeline of breast growth or the type of tissue involved. Including these elements could improve clinical decision-making and streamline management.
Further research is needed to develop a comprehensive classification system for gigantomastia that assists in treatment planning and a deepens understanding of PASH.
CONCLUSIONS
The cause of gigantomastia remains unclear. Here, we present the case of a healthy female patient who experienced rapid breast enlargement, progressing from a B cup to a triple G cup over 6 months, beginning 1 week following Pfizer COVID-19 vaccination.
She underwent bilateral reduction mammoplasty, complicated by intraoperative bleeding, necessitating postoperative transfusions. Surgical specimens confirmed PASH. Further research is needed to understand PASH etiology, refine gigantomastia classification, and explore the potential link between the Pfizer vaccine, gigantomastia, and PASH.
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