Gynecomastia Due to Hormone Therapy for Advanced Prostate Cancer: A Report of Ten Surgically Treated Cases and a Review of Treatment Options

Prezioso, Domenico; Piccirillo, G.; Galasso, Raffaele; Altieri, Vincenzo; Mirone, Vincenzo; Lotti, T.

doi:10.1177/030089160409000409

Cited by 23 publications

(8 citation statements)

References 33 publications

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“…Liposuction can correct abnormal and excessive collections of adipose tissue and is regarded by many investigators as one of the most effective treatments for gynaecomastia as it is associated with few adverse sequelae (Figures 2–4). However, it is important to underline that liposuction is probably less effective in patients with true glandular gynaecomastia (15; see below). Classically, during liposuction, a narrow cannula is inserted and used to vacuum the adipose tissue.…”

Section: Treatmentmentioning

confidence: 99%

Management of gynaecomastia: an update

Gikas

Mokbel

2007

International Journal of Clinical Practice

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Gynaecomastia, a benign enlargement of the male breast as a result of proliferation of the glandular component, is common, being present in 30-50% of healthy men. It may be an incidental finding, an acute unilateral or bilateral tender breast enlargement or a progressive painless enlargement of the male breast. A general medical history and careful physical examination, looking for features suggestive of breast cancer, often suffice for evaluation in patients without symptoms or those with incidentally discovered breast enlargement. If the gynaecomastia is of recent onset, a more detailed evaluation, including selected laboratory tests to search for an underlying cause is necessary. Treatment depends on the cause: an offending drug may need to be withdrawn or alternatively radiation, surgery and/or medical therapy may be necessary. The use of a combination of surgical excision and liposuction through a periareolar incision represents the surgical approach of choice.

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Section: Treatmentmentioning

confidence: 99%

Management of gynaecomastia: an update

Gikas

Mokbel

2007

International Journal of Clinical Practice

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“…In addition to history and physical examination, diagnostic aids include ultrasound, mammography, hormonal evaluation, and biopsy (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Treatment options include waiting for resolution, drug withdrawal or substitution, analgesics, radiotherapy (17), surgical excision (18)(19)(20)(21), and anti-estrogen or aromatase inhibitor therapy (22,23).…”

mentioning

confidence: 99%

Management of Senescent Gynecomastia in the Veterans Health Administration

et al. 2011

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Senescent gynecomastia is common in Veterans Health Administration patients because of clinical characteristics in the population, mainly obesity and the use of numerous etiologic drugs. To assess management of the disease, we studied patients treated between January 1, 2003 and December 31, 2007, in the Veterans Affairs-Tennessee Valley Healthcare System. Four hundred and fifty-four cases of senescent gynecomastia were retrieved from 670 charts addressing breast complaints (positive predictive value = 68%). Average patient age was 68.5 years. Mean body mass index was 29.7. Ninety-two percent of patients were using multiple medications associated with gynecomastia. Medications were considered at least partially etiologic in 79.3% of cases. Medical conditions caused gynecomastia in 13.7%. Over 50% of patients underwent diagnostic imaging studies. One-fifth of patients were tested for etiologic endocrine tumors. Yield on this testing was 1.1% (1/93). Ninety-four percent of patients were managed nonoperatively. Case management in the Tennessee Valley Healthcare System was generally correct, though there was excessive use of imaging, invasive diagnostic procedures, and endocrine assessment. Senescent gynecomastia, a benign disease, can usually be diagnosed by history and physical examination, requires little diagnostic testing, and should be treated nonoperatively.

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“…The reason is that prospective randomized controlled surgical trials are lacking. To date, only one case report and one case series have been published concerning the surgical management of bicalutamide-induced gynecomastia 22,23 . In both surgical studies, histopathologic examination of the excised glands from patients who received bicalutamide for pca showed a decrease in ductal proliferation and a progressive increase in fibrosclerotic tissue.…”

Section: Discussionmentioning

confidence: 99%

Optimal Prophylactic and Definitive Therapy for Bicalutamide-Induced Gynecomastia: Results of a Meta-analysis

et al. 2012

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important risk factor for cardiotoxicity (p = 0.006). A funnel plot of the meta-analysis showed significant heterogeneity (Egger test p < 0.00001) because of low sample size. ConclusionsOur meta-analysis suggests using prophylactic tamoxifen 20 mg daily as the first-line preventive measure and radiotherapy as the first-line treatment option for bicalutamide-induced gynecomastia. Aromatase inhibitors and weekly tamoxifen are not recommended. KEY WORDSMeta-analysis, bicalutamide-induced gynecomastia, prostate cancer

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Gynecomastia Due to Hormone Therapy for Advanced Prostate Cancer: A Report of Ten Surgically Treated Cases and a Review of Treatment Options

Cited by 23 publications

References 33 publications

Management of gynaecomastia: an update

Management of gynaecomastia: an update

Management of Senescent Gynecomastia in the Veterans Health Administration

Optimal Prophylactic and Definitive Therapy for Bicalutamide-Induced Gynecomastia: Results of a Meta-analysis

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