Abstract
Gynecomastia – the enlargement of male breast tissue in men – is a relatively common finding, frequently observed in newborns, adolescents, and old men. Physiological gynecomastia, occurring in almost 25% of cases, is benign and self-limited; on the other hand, several conditions and drugs may induce proliferation of male breast tissue. True gynecomastia is a common feature often related to estrogen excess and/or androgen deficiency as a consequence of different endocrine disorders. Nonendocrine illnesses, including liver failure and chronic kidney disease, are another cause of gynecomastia, which should be considered. Due to the diversity of possibly etiologies, including neoplasm, performing a careful history and physical examination is imperative. Once gynecomastia has been diagnosed, treatment of the underlying cause is warranted. If no underlying cause is discovered, then close observation is appropriate. If gynecomastia is severe, however, medical therapy can be attempted and if ineffective, glandular tissue can be removed surgically.
References
Bannayan GA, Hajdu SI. Gynecomastia: clinicopathologic study of 351 cases. Am J Clin Pathol. 1972;57:431–7.
Basaria S. Androgen abuse in athletes: detection and consequences. J Clin Endocrinol Metab. 2010;95(4):1533–43.
Bembo SA, Carlson HE. Gynecomastia: its features, and when and how to treat it. Cleve Clin J Med. 2004;71(6):511–7.
Birzniece V. Doping in sport: effects, harm and misconceptions. Intern Med J. 2015;45(3):239–48.
Bowman JD, Kim H, Bustamante JJ. Drug-induced gynecomastia. Pharmacotherapy. 2012;32(12):1123–40.
Braunstein GD. Aromatase and gynecomastia. Endocr Relat Cancer. 1999;6(2):315–24.
Braunstein GD. Clinical practice. Gynecomastia. N Engl J Med. 2007;357(12):1229–37.
Bravo ML, Pinto MP, Gonzalez I, Oliva B, Kato S, Cuello MA, Lange CA, Owen GI. Progesterone regulation of tissue factor depends on MEK1/2 activation and requires the prolinerich site on progesterone receptor. Endocrine. 2015;48(1):309–20.
Brinton LA. Breast cancer risk among patients with Klinefelter syndrome. Acta Paediatr. 2011;100(6):814–8.
Carlson HE. Approach to the patient with gynecomastia. J Clin Endocrinol Metab. 2011;96:15–21.
Chentli F, Bekkaye I, Azzoug S. Feminizing adrenocortical tumors: literature review. Indian J Endocrinol Metab. 2015;19(3):332–9.
Cuhaci N, Polat SB, Evranos B, Ersoy R, Cakir B. Gynecomastia: clinical evaluation and management. Indian J Endocrinol Metab. 2014;18(2):150–8.
Di Luigi L, Romanelli F, Sgro P, Lenzi A. Andrological aspects of physical exercise and sport medicine. Endocrine. 2012;42(2):278–84.
Dickson G. Gynecomastia. Am Fam Physician. 2012;85(7):716–22.
Eren E, Edgunlu T, Korkmaz HA, Cakir ED, Demir K, Cetin ES, Celik SK. Genetic variants of estrogen beta and leptin receptors may cause gynecomastia in adolescent. Gene. 2014;541(2):101–6.
Fagerlund A, Lewin R, Rufolo G, Elander A, Santanelli di Pompeo F, Selvaggi G. Gynecomastia: a systematic review. J Plast Surg Hand Surg. 2015;49(6):311–8.
Farooqi IS, O’Rahilly S. 20 Years of leptin: human disorders of leptin action. J Endocrinol. 2014;223(1):T63–70.
Ferreira M, Mesquita M, Quaresma M, Andre S. Prolactin receptor expression in gynaecomastia and male breast carcinoma. Histopathology. 2008;53(1):56–61.
Fodor PB. Breast cancer in a patient with gynecomastia. Plast Reconstr Surg. 1989;84:976–9.
Gómez-Raposo C, Zambrana Tévar F, Sereno Moyano M, López Gómez M, Casado E. Male breast cancer. Cancer Treat Rev. 2010;36(6):451–7.
Habib CN, Al-Abd AM, Tolba MF, Khalifa AE, Khedr A, Mosli HA, Abdel-Naim AB. Leptin influences estrogen metabolism and accelerates prostate cell proliferation. Life Sci. 2015;121(C):10–5.
Iglesias P, Carrero JJ, Diez JJ. Gonadal dysfunction in men with chronic kidney disease: clinical features, prognostic implications and therapeutic options. J Nephrol. 2012;25(1):31–42.
Jannini EA, Ulisse S, D’Armiento M. Thyroid hormone and male gonadal function. Endocr Rev. 1995;16(4):443–59.
Johnson RE, Murad MH. Gynecomastia: pathophysiology, evaluation, and management. Mayo Clin Proc. 2009;84:1010–5.
Johnson RE, Kermott CA, Murad MH. Gynecomastia—evaluation and current treatment options. Ther Clin Risk Manag. 2011;7:145–8.
Jones DJ, Holt SD, Surtees P, Davison DJ, Coptcoat MJ. A comparison of danazol and placebo in the treatment of adult idiopathic gynaecomastia: results of a prospective study in 55 patients. Ann R Coll Surg Engl. 1990;72:296–8.
Lanfranco F, Kamischke A, Zitzmann M, Nieschlag E. Klinefelter’s syndrome. Lancet. 2004;364(9430):273–83.
Mathur R, Braunstein GD. Gynecomastia: pathomechanisms and treatment strategies. Horm Res. 1997;48(3):95–102.
Matsumoto AM, Bremner WJ. Testicular disorders. In: Williams Textbook of Endocrinology – 13th Edition, S. Melmed, K.S. Polonsky, P. Reed Larsen, H.M. Kronenberg, Eds., Elsevier, Philadelphia; 2016: 1219–1233.
Narula HS, Carlson HE. Gynaecomastia–pathophysiology, diagnosis and treatment. Nat Rev Endocrinol. 2014;10(11):684–498.
Ng ST, Zhou J, Adesanya OO, Wang J, LeRoith D, Bondy CA. Growth hormone treatment induces mammary gland hyperplasia in aging primates. Nat Med. 1997;3(10):1141–4.
Nieschlag E, Vorona E. Mechanisms in endocrinology: medical consequences of doping with anabolic androgenic steroids: effects on reproductive functions. Eur J Endocrinol. 2015;173(2):R47–58.
Rohrich RJ, Ha RY, Kenkel JM, Adams Jr WP. Classification and management of gynecomastia: defining the role of ultrasound-assisted liposuction. Plast Reconstr Surg. 2003;111:909–23.
Rokutanda N, Iwasaki T, Odawara H, Nagaoka R, Miyazaki W, Takeshita A, Koibuchi Y, Horiguchi J, Shimokawa N, Iino Y, Morishita Y, Koibuchi N. Augmentation of estrogen receptor-mediated transcription by steroid and xenobiotic receptor. Endocrine. 2008;33(3):305–16.
Sansone A, Romanelli F, Sansone M, Lenzi A, Di Luigi L. Gynecomastia and hormones. Endocrine. 2017;55(1):37–44.
Simon BE, Hoffman S, Kahn S. Classification and surgical correction for gynecomastia. Plast Reconstr Surg. 1973;51:48.
Sinclair M, Grossmann M, Gow PJ, Angus PW. Testosterone in men with advanced liver disease: abnormalities and implications. J Gastroenterol Hepatol. 2015;30(2):244–51.
Sloand E. Pediatric and adolescent breast health. Lippincotts Prim Care Pract. 1998;2(2):170–5.
Stevenson SM, Lowrance WT. Epidemiology and diagnosis of testis cancer. Urol Clin N Am. 2015;42(3):269–75.
Swerdloff RS, Ng JCM. Gynecomastia: etiology, diagnosis, and treatment. In: De Groot LJ, Chrousos G, Dungan K, Feingold KR, Grossman A, Hershman JM, Koch C, Korbonits M, McLachlan R, New M, Purnell J, Rebar R, Singer F, Vinik A, editors. Endotext [Internet]. South Dartmouth: MDText.com, Inc.; 2015. 2000-. Available from http://www.ncbi.nlm.nih.gov/books/NBK279105/
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing AG
About this entry
Cite this entry
Zavattaro, M., Motta, G., Allasia, S., Lanfranco, F. (2017). Gynecomastia. In: Simoni, M., Huhtaniemi, I. (eds) Endocrinology of the Testis and Male Reproduction. Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-319-29456-8_30-1
Download citation
DOI: https://doi.org/10.1007/978-3-319-29456-8_30-1
Received:
Accepted:
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-29456-8
Online ISBN: 978-3-319-29456-8
eBook Packages: Springer Reference MedicineReference Module Medicine