Gynecomastia

What is gynecomastia

Gynecomastia is overdevelopment of the male breast. In response to too much estrogen (a female hormone) or too little testosterone (a male hormone), the glandular tissue of the breast swells and forms a breast bud (enlarged breast)

What are the symptoms of gynecomastia

In addition to having enlarged breasts, men or boys with gynecomastia may notice their breasts feel rubbery or firm. Boys may have a breast bud on one or both sides about the size of a nickel or quarter. Breast buds are common in adolescent boys during puberty. They may last up to 2 years, but they tend to go away within the first year

What causes gynecomastia

In newborns, gynecomastia is caused by estrogen from the mother. Breast buds are common in baby boys. Breast buds tend to go away gradually by 6 months of age, but they can last longer in some babies.

In preteen boys, breast buds are common during puberty. The buds may last up to 2 years, but they tend to go away within the first year. Gynecomastia can also be caused by an estrogen-producing tumor.

In teen boys, gynecomastia is caused by the hormonal changes of puberty. Gynecomastia occurs in many boys during early puberty to middle puberty. It usually goes away within 6 months to 2 years.

In adult males, gynecomastia is usually caused by another condition, such as liver or lung cancer, cirrhosis of the liver, overactive thyroid, or by hormone problems, such as cancer of the pituitary gland, adrenal glands, or testicles. Alcohol, marijuana, methamphetamine, and heroin use also may cause gynecomastia. In older males, gynecomastia can be caused by a change in hormone levels

Use of certain medicines may also cause gynecomastia, including :

  • Steroids, such as prednisone or dexamethasone

  • Medicines used to treat ulcers (such as cimetidine)

  • Medicines used to treat epilepsy (such as phenytoin [Dilantin])

  • Digitalis and other heart medicines

  • Chemotherapy drugs, especially alkylating agents, a family of anticancer drugs that interfere with cell DNA and inhibit cancer cell growth

  • Antiandrogen drugs (such as flutamide, cyproterone, and spironolactone)

  • Antianxiety and antidepressant medicines (such as diazepam [Valium] and tricyclic antidepressants)

How is gynecomastia diagnosed?

Gynecomastia can usually be diagnosed from a physical exam and medical history. In most cases, tests are not necessary. But if the breast lump is unusually large, one-sided, tender, or hard and fixed, a biopsy may be done to rule out other problems.

Any man who finds a one-sided breast lump should let his doctor know if he has close relatives who have had breast cancer (mother, sister, or daughter). If there is any concern about cancer, a lump can be checked with a biopsy or surgery

Blood Test

Your evaluation may include the performance of specific blood tests, including (but not limited to) cell counts, measurement of various blood chemistries and markers of inflammation. We can measure many things in your blood such as salts, blood cell counts and protein markers specific to the heart (one is called BNP). Additional tests may include blood chemistries, evaluation of liver and kidney functions, and genetic studies). In some cases, genetic testing may be recommended. In addition, we may ask you to join our ongoing studies by allowing us to collect and store some of your blood for future analysis

Urinalysis

Urinalysis is a laboratory examination of urine for various cells and chemicals, such as red blood cells, white blood cells, infection, or excessive protein. Urinalysis breaks down the components of urine to check for the presence of drugs, blood, protein, and other substances. Blood in the urine (hematuria) may be the result of a benign (noncancerous) condition, but it can also indicate an infection or other problem. High levels of protein in the urine (proteinuria) may indicate a kidney or cardiovascular problem

Gynecomastia treatments in children

Gynecomastia in babies and teens normally does not require treatment and will usually go away on its own. If it is caused by medicine or disease, stopping the medicine or treating the disease will often cure the gynecomastia. If it is caused by a lack of testosterone and increase in estrogen, hormonal treatment may be prescribed. Surgery may be a choice for some men if other treatments have not worked.

Gynecomastia surgery in men

The type of anesthesia used will depend on many factors, including your preference, the surgeon, the extent of the growth, your age, and the size of the incision. Either local or general anesthesia may be utilized. The surgeon often will make marks on the skin before surgery to indicate the areas to be removed.

There are different types of surgical procedures that may be utilized, including the following:

  • Suction lipectomy : This is a form of liposuction that allows for tapering of the edges of the tissue without unwanted side effects. Complicated gynecomastia conditions may require an open surgical procedure, in which an incision is placed into the breast tissue and the excess tissue is removed

  • Endoscopic surgery : This newer procedure uses a small, flexible tube with a light and a camera lens at the end (endoscope) to examine the inside of the breast. Tissue is then removed without placing a large, open, surgical incision. Data regarding the accuracy or complications of this technique are not available at this time

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