Gynecomastia natural history, complications and prognosis: Difference between revisions

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__NOTOC__
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{{Gynecomastia}}
{{Gynecomastia}}
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{{CMG}}; {{AE}} {{HS}}


==Overview==
==Overview==
==Natural History==
If left untreated patients with gynecomastia may progress to develop [[Psychological stress|psychosocial stresses]] and rarely [[breast cancer]]. The majority of [[physiological]] gynecomastia is self-limited. [[Pathological]] gynecomastia has an excellent [[prognosis]] and responds well to treatment. [[Pharmacological]] [[gynecomastia]] responds very well to the cessation of the offending agent.
==Complications==
 
==Prognosis==
==Natural History, Complications, and Prognosis==
Gynecomastia is not physically harmful, but in some cases can be an indicator of other more dangerous underlying conditions. Growing glandular tissue, typically from some form of hormonal stimulation, is often tender or painful. Furthermore, it can frequently present social and psychological difficulties for the sufferer.<ref>{{cite web | url = http://www.annalsplasticsurgery.com/pt/re/annps/abstract.00000637-200408000-00001.htm;jsessionid=F9bRttLWlcgHnBWVVgG3xcHwF1KbpJTPbgyLjKvQJXG977J7s1pP!1570379021!-949856144!8091!-1  | title = ''Gynecomastia: An Outcome Analysis'' | author = Wiesman, IM. et al.}}</ref> Weight loss can alter the condition in cases where it is triggered by obesity, but losing weight will not reduce the glandular component and patients cannot target areas for weight lossMassive weight loss can result in sagging tissues about the chest, chest [[ptosis (breasts)|ptosis]], or drooping chest.
 
===Natural History===
* The signs and symptoms of [[gynecomastia]] typically develop in [[neonatal]], [[pubertal]] age or in the [[elderly]].<ref name="pmid8421478">{{cite journal| author=Braunstein GD| title=Gynecomastia. | journal=N Engl J Med | year= 1993 | volume= 328 | issue= 7 | pages= 490-5 | pmid=8421478 | doi=10.1056/NEJM199302183280708 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8421478  }} </ref><ref name="pmid2137877">{{cite journal |vauthors=Biro FM, Lucky AW, Huster GA, Morrison JA |title=Hormonal studies and physical maturation in adolescent gynecomastia |journal=J. Pediatr. |volume=116 |issue=3 |pages=450–5 |year=1990 |pmid=2137877 |doi= |url=}}</ref><ref name="pmid24872741">{{cite journal| author=Lemaine V, Cayci C, Simmons PS, Petty P| title=Gynecomastia in adolescent males. | journal=Semin Plast Surg | year= 2013 | volume= 27 | issue= 1 | pages= 56-61 | pmid=24872741 | doi=10.1055/s-0033-1347166 | pmc=3706045 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24872741  }} </ref>
* Without treatment [[gynecomastia]] has some associated risk of [[breast cancer]], however, the majority of [[physiological]] [[gynecomastia]] resolves in months to years.
 
===Complications===
Complications of [[gynecomastia]] include:<ref name="pmidorg/10.1016/j.amjmed.2016.01.009">{{cite journal| author=Schmoldt A, Benthe HF, Haberland G| title=Digitoxin metabolism by rat liver microsomes. | journal=Biochem Pharmacol | year= 1975 | volume= 24 | issue= 17 | pages= 1639-41 | pmid=org/10.1016/j.amjmed.2016.01.009 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10  }} </ref><ref name="pmid26408934">{{cite journal| author=Ordaz DL, Thompson JK| title=Gynecomastia and psychological functioning: A review of the literature. | journal=Body Image | year= 2015 | volume= 15 | issue=  | pages= 141-8 | pmid=26408934 | doi=10.1016/j.bodyim.2015.08.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26408934  }} </ref><ref name="pmid26151806">{{cite journal| author=Rew L, Young C, Harrison T, Caridi R| title=A systematic review of literature on psychosocial aspects of gynecomastia in adolescents and young men. | journal=J Adolesc | year= 2015 | volume= 43 | issue=  | pages= 206-12 | pmid=26151806 | doi=10.1016/j.adolescence.2015.06.007 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26151806  }} </ref>
* Persistent [[pubertal]] gynecomastia
*[[Breast cancer]]
*[[Psychological stress]] like:
**[[depression]]
**Reduced [[self-esteem]]
**Body dissatisfaction
 
===Prognosis===
Gynecomastia prognosis is good overall:<ref>{{cite web | url = http://www.annalsplasticsurgery.com/pt/re/annps/abstract.00000637-200408000-00001.htm;jsessionid=F9bRttLWlcgHnBWVVgG3xcHwF1KbpJTPbgyLjKvQJXG977J7s1pP!1570379021!-949856144!8091!-1  | title = ''Gynecomastia: An Outcome Analysis'' | author = Wiesman, IM. et al.}}</ref><ref name="pmid21712702">{{cite journal| author=Li CC, Fu JP, Chang SC, Chen TM, Chen SG| title=Surgical treatment of gynecomastia: complications and outcomes. | journal=Ann Plast Surg | year= 2012 | volume= 69 | issue= 5 | pages= 510-5 | pmid=21712702 | doi=10.1097/SAP.0b013e318222834d | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21712702  }} </ref><ref name="pmid28451801">{{cite journal| author=Choi BS, Lee SR, Byun GY, Hwang SB, Koo BH| title=The Characteristics and Short-Term Surgical Outcomes of Adolescent Gynecomastia. | journal=Aesthetic Plast Surg | year= 2017 | volume=  | issue=  | pages=  | pmid=28451801 | doi=10.1007/s00266-017-0886-z | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28451801 }} </ref>
* Physiological gynecomastia has an excellent [[prognosis]] and the majority of [[physiological]] gynecomastia resolve spontaneously.
* Pathological gynecomastia also responds well to treatment or removal of the underlying cause.
* [[Pharmacological]] gynecomastia responds very well to the cessation of the offending agent.
* Persistent gynecomastia can cause [[psychological stress]] and increases the risk of [[breast cancer]].


==References==
==References==
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Latest revision as of 23:29, 15 November 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Husnain Shaukat, M.D [2]

Overview

If left untreated patients with gynecomastia may progress to develop psychosocial stresses and rarely breast cancer. The majority of physiological gynecomastia is self-limited. Pathological gynecomastia has an excellent prognosis and responds well to treatment. Pharmacological gynecomastia responds very well to the cessation of the offending agent.

Natural History, Complications, and Prognosis

Natural History

Complications

Complications of gynecomastia include:[4][5][6]

Prognosis

Gynecomastia prognosis is good overall:[7][8][9]

  • Physiological gynecomastia has an excellent prognosis and the majority of physiological gynecomastia resolve spontaneously.
  • Pathological gynecomastia also responds well to treatment or removal of the underlying cause.
  • Pharmacological gynecomastia responds very well to the cessation of the offending agent.
  • Persistent gynecomastia can cause psychological stress and increases the risk of breast cancer.

References

  1. Braunstein GD (1993). "Gynecomastia". N Engl J Med. 328 (7): 490–5. doi:10.1056/NEJM199302183280708. PMID 8421478.
  2. Biro FM, Lucky AW, Huster GA, Morrison JA (1990). "Hormonal studies and physical maturation in adolescent gynecomastia". J. Pediatr. 116 (3): 450–5. PMID 2137877.
  3. Lemaine V, Cayci C, Simmons PS, Petty P (2013). "Gynecomastia in adolescent males". Semin Plast Surg. 27 (1): 56–61. doi:10.1055/s-0033-1347166. PMC 3706045. PMID 24872741.
  4. Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID org/10.1016/j.amjmed.2016.01.009 Check |pmid= value (help).
  5. Ordaz DL, Thompson JK (2015). "Gynecomastia and psychological functioning: A review of the literature". Body Image. 15: 141–8. doi:10.1016/j.bodyim.2015.08.004. PMID 26408934.
  6. Rew L, Young C, Harrison T, Caridi R (2015). "A systematic review of literature on psychosocial aspects of gynecomastia in adolescents and young men". J Adolesc. 43: 206–12. doi:10.1016/j.adolescence.2015.06.007. PMID 26151806.
  7. Wiesman, IM.; et al. "Gynecomastia: An Outcome Analysis".
  8. Li CC, Fu JP, Chang SC, Chen TM, Chen SG (2012). "Surgical treatment of gynecomastia: complications and outcomes". Ann Plast Surg. 69 (5): 510–5. doi:10.1097/SAP.0b013e318222834d. PMID 21712702.
  9. Choi BS, Lee SR, Byun GY, Hwang SB, Koo BH (2017). "The Characteristics and Short-Term Surgical Outcomes of Adolescent Gynecomastia". Aesthetic Plast Surg. doi:10.1007/s00266-017-0886-z. PMID 28451801.

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