Abstract
Gynecomastia is the commonest breast condition in male, which can cause significant psychological distress and anxiety to the patient. It refers to the benign enlargement of the male breast caused by proliferation of glandular breast tissue due to an imbalance between the inhibitory effect of androgen and stimulatory effect of estrogen. Gynecomastia can be physiological during neonatal period, puberty or old age. Various drugs, systemic disorders, benign or malignant tumours and hypogonadism can also lead to gynecomastia, while about 25% of cases are idiopathic. Gynecomastia should be differentiated from pseudogynecomastia (adipomastia), which is characterized by excessive accumulation of adipose tissue without glandular proliferation. A detailed history and examination helps to exclude differential diagnosis, identify the underlying etiology and to assess the severity of the disease and the concerns of the patient. The management of gynecomastia depends on the underlying etiology and the concerns of the patient. This may include interventions for relief of pain or discomfort, restoration of normal appearance and reassurance regarding cancer. Treatment options include watchful waiting, pharmacotherapy and surgery. Sri Lanka Journal of Diabetes, Endocrinology and Metabolism 2015; 5: 23-27
Highlights
Gynecomastia refers to benign enlargement of the male breast caused by proliferation of glandular breast tissue (1)
The early stages of gynecomastia are characterized by hyperplasia of ductal and peri ductal tissues with increased stromal fibroblastic proliferation and periductal inflammation leading to pain or tenderness in the breast
Senile gynecomastia occurs in 24-65% of men at 50 to 80 years of age and is thought to be due to increased adiposity with aging (1)
Summary
Gynecomastia refers to benign enlargement of the male breast caused by proliferation of glandular breast tissue (1). It is the commonest breast condition affecting males and it sprevalence varies between 32-65% according to factors like age, lifestyle etc (2). Gynecomastia can cause significant psychological distress and anxiety to the patient and mostly benign may signal a sinister underlying disease. Proper evaluation and treatment is of paramount importance
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