Gynecomastia of the male breast
- Gynecomastia is the benign hypertrophy of the male breast
- asymptomatic or painful
- unilateral or bilateral
- just below the areolar region
Age distribution
3 peaks
- transiently during neonatal period due to motherly estrogrens
- puberty
- adulthood
Causes of Gynecomastia
- Illicit drug use, especially marijuana
- Renal, Liver disease
- Neoplasms
- Hyperparathyroidism
Gynecomastia’s association with cancer
- Testicular cancer
- BRCA2 genetic multation may lead to male breast cancer
Diagnostics for Gynecomastia
For the older patient with no obvious etiology consider:
- LFT
- BUN
- Creatinine
- Thyroid hormone
- Prolactin level
- FSAH, LH, DHEA
- Testosterone
- Bilateral mammorgram
- FNA (fine needle aspiration) can be diagnostic or core needle biopsy, usually not a need for excisional biopsy. Thus an excisional biopsy wouldn’t be a first line diagnostic tool in gynecomastia.