Gynaecomastia

Abstract

Gynaecomastia is the most frequent benign condition of the male breast and is ranging from 30 to 66% in all group ages. The typical clinical appearance of gynaecomastia is that of subareolar, bilateral, symmetrical discoid enlargement of breast tissue, while its histological features consist of proliferation of mammary gland and stroma. Gynaecomastia can be classified to three subcategories, idiopathic, primary and secondary. Primary gynaecomastia is usually seen in newborns, adolescents and elderly people, while secondary is induced by endocrine diseases, chronic systemic conditions or drugs. In idiopathic gynaecomastia no underlying causative factor is recognized. A detailed medical history, careful physical examination and endocrine work-up usually demonstrate the cause and rule out the probable presence of a neoplasm Watchful waiting and close follow-up is the standard of care in most of the patients. Nowadays, pharmacologic agents (androgens-antioestrogens-reductase inhibitors) are used in the therapeutic approach of pathologic gynaecomastia of recent onset, whereas surgery is kept for long standing gynaecomastia, psychological-aesthetic reasons and cases of suspected breast cancer.