Gynecomastia: Clinicopathologic Study of 351 Cases

Bannayan, George A.; Hajdu, Steven I.

doi:10.1093/ajcp/57.4.431

Cited by 158 publications

(75 citation statements)

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“…However, when using these drugs or any other type of medical therapy in any patient with gynecomastia, it is important to remember that drugs would probably be most effective during the early, florid (painful) phase of gynecomastia that is present during the first 6 months after the onset of the disorder, during which there is ductal proliferation and epithelial and stromal hyperplasia. After the gynecomastia has been present for over a year, the proliferative phase is replaced by a fibrotic stage in which there is increased stromal hyalinization and dilatation of the ducts -a stage during which medications are unlikely to be beneficial (Nicolis et al 1971, Bannayan & Hajdu 1972. Also, when studying medications, one must keep in mind the high rate of spontaneous regression of the disease (Braunstein 1993).…”

Section: Figurementioning

confidence: 99%

Aromatase and gynecomastia.

Braunstein

1999

Endocrine-Related Cancer

147

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An imbalance between estrogen action relative to androgen action at the breast tissue level results in gynecomastia. Enhancement of aromatization of androgens to estrogens is important in the pathogenesis of gynecomastia associated with obesity, aging, puberty, liver disease, thyrotoxicosis, 17-oxosteroid reductase deficiency. Klinefelter's syndrome, and neoplasms of the testes, adrenals and liver. A primary aromatase excess syndrome with exuberant gynecomastia had been found both sporadically and in a familial setting. Although aromatase inhibition would appear to be an important class of drugs to treat gynecomastia, relatively little published data with these drugs exist and most concern the use of ∆ 1 -testolactone, which reduces the size of the breast glandular tissue, but does not completely ameliorate the problem. Studies with the newer generation of more potent aromatase Endocrine-Related Cancer (1999) 6 315-324 inhibitors need to be carried out.

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Section: Figurementioning

confidence: 99%

Aromatase and gynecomastia.

Braunstein

1999

Endocrine-Related Cancer

147

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“…All causes share an imbalance of androgens and estrogens with a decreased testosterone-to-estradiol ratio, which directly affects the breast tissue [12]. Altered ratios of androgens and estrogens or the increased sensitivity of breast tissue to normal circulating estrogen levels gives rise to ductal hyperplasia, elongation and branching of the ducts correlated with proliferation of fibroblasts and neovascularization [13,14], which altogether form the clinical appearance of GM vera ( fig. 1).…”

Section: Introductionmentioning

confidence: 99%

Surgical Strategies in the Treatment of Gynecomastia Grade I-II: The Combination of Liposuction and Subcutaneous Mastectomy Provides Excellent Patient Outcome and Satisfaction

et al. 2015

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Background: Gynecomastia (GM) is a benign condition with glandular tissue enlargement of the male breast. GM is classified into 4 grades of increasing severity. We describe a series of GM grade I-II, diagnosed, treated surgically and analyzed regarding feasibility, complication rate, and satisfaction. Methods: From 2005 to 2012, a chart review was performed for 53 patients. Preoperative examination included endocrine and urological examination and exclusion of other pathological conditions. The surgical technique consisted of liposuction through an inframammarian-fold incision and excision of the glandular tissue by a minimal periareolar approach. Results: A total number of 53 male patients with 104 breasts were available for analysis. By liposuction, a median of 300 ml (range: 10-1000 ml) was aspirated from each breast and 25.1 g (range: 3-233 g) gland tissue was resected. Surgery lasted between 25 and 164 min per patient (median: 72 min). 2 postoperative hemorrhages occurred (n = 2, 3.8%). 2 patients underwent re-operation due to cosmetic reasons (n = 2, 3.8%). Conclusions: This analysis demonstrates that treatment of GM grade I-II can easily be performed by liposuction combined with subcutaneous resection of the glandular tissue as a minimally invasive and low-impact surgical treatment with a low rate of complications and excellent patient satisfaction. Preoperative workup is important to rule out specific diseases or malignancy causing the GM.

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“…This fibrous tissue cannot be removed conservatively and proceeding with surgical management must be considered [23]. …”

Section: Conservative and Surgical Managementmentioning

confidence: 99%

Gynecomastia - Conservative and Surgical Management

Baumann¹

2018

Breast Care

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Gynecomastia is defined as a unilateral or bilateral persistent benign mammary gland enlargement in men. Prevalence of asymptomatic gynecomastia is up to 65%. True gynecomastia must be distinguished from pseudogynecomastia. Typically, in true gynecomastia, a solid tissue mass is palpable below the nipple-areolar complex. Malignant changes such as male mammary carcinoma must always be ruled out. The causes of gynecomastia are diverse. An imbalance of female to male hormones triggers the onset of the disease. This imbalance can be caused by endogenous diseases like hyperthyroidism, chronic liver disease, primary or secondary gonadal failure, androgen resistance syndromes, medication, and drug abuse. A series of heart or hypertension medications can also trigger gynecomastia. A basic requirement of proper therapy planning is knowledge of the triggers and possible drug therapy options. Inquiring about the patient's lifestyle and medication history is essential. Drug therapy with tamoxifen may be considered at an early stage. For gynecomastia persisting over 12 months, surgical excision is the treatment of choice, and there are several surgical options available depending on the grade of the gynecomastia. A thoughtful approach to managing this condition can lead to high patient satisfaction.

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Gynecomastia: Clinicopathologic Study of 351 Cases

Cited by 158 publications

References 0 publications

Aromatase and gynecomastia.

Aromatase and gynecomastia.

Surgical Strategies in the Treatment of Gynecomastia Grade I-II: The Combination of Liposuction and Subcutaneous Mastectomy Provides Excellent Patient Outcome and Satisfaction

Gynecomastia - Conservative and Surgical Management

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