Gynaecomastia

Breast tissue enlargement in men and pubertal boys is very common. Not unusual for a teenager to arrive with his parents to discuss this issue. Gynaecomastia is derived from Greek -mastos means women and Gynae we all know is a woman. This chart on Gynaecomastia on A4Medicine explains the pathophysiology and causes of gynaecomastia. A brief assessment is followed by some practical management tips. Which investigations to order are mentioned and currently, we do not have a guideline on management of gynaecomastia. Use of Tamoxifen is discussed with evidence of benefit in the Nottingham study

Benign proliferation of glandular breast tissue in men characterized by presence of rubbery or firm mass extending concentrically from the nipples Common - up to 35 % of men Most common disorder of male breast Can occur at any age but ↑ common in older menPeak in pubertal boys Oestrogens are major hormones responsible for proliferation of breast tissue in both sexes whereas testosterone is a potent inhibitor of breast growth Can result from hormone imbalance- either an excess of oestrogens or oestrogen precursors or a reduction in androgens or impairment of their actions

Presentation-Presents usually with a swelling of the breast , often unilateral...