Gynecomastia: pathophysiology, evaluation, and management.
Gynecomastia, defined as benign proliferation of male breast glandular tissue, is usually caused by increased estrogen activity, decreased testosterone activity, or the use of numerous medications. Although a fairly common presentation in the primary care setting and mostly of benign etiology, it can cause patients considerable anxiety. The initial step is to rule out pseudogynecomastia by careful history taking and physical examination. A stepwise approach that includes imaging and laboratory testing to exclude neoplasms and endocrinopathies may facilitate cost-effective diagnosis. If results of all studies are normal, idiopathic gynecomastia is diagnosed. The evidence in this area is mainly of observational nature and lower quality.
Johnson
Ruth E
RE
Division of Preventive, Occupational and Aerospace Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Murad
M Hassan
MH
D000046:Academic Medical Centers; D000367:Age Factors; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage*; D001707:Biopsy, Needle; D018567:Breast Neoplasms, Male / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D004967:Estrogens / Q000378:metabolism; D005500:Follow-Up Studies; D006177:Gynecomastia / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008327:Mammography; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D008910:Minnesota; D018570:Risk Assessment; D012720:Severity of Illness Index; D013739:Testosterone / Q000378:metabolism
D018931:Antineoplastic Agents, Hormonal; D004967:Estrogens; D013739:Testosterone