Breast lumps causes: Difference between revisions

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Revision as of 17:50, 31 December 2018

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jyostna Chouturi, M.B.B.S [2], João André Alves Silva, M.D. [3] Shadan Mehraban, M.D.[4]

Overview

Breast lumps, or breast palpable masses, are the second most common breast symptoms, after mastalgia. These must be distinguished from the normal nodularity of the breast.^[1] They can be of cystic or solid nature, which can’t be appropriately distinguished just based on physical examination.^[2] Usually a breast lump is only palpable after reaching 2 cm of diameter.^[3] Breast lumps are more commonly found in premenopausal women, becoming less frequent with age.^[4] The most common etiologies are fibroadenomas, cysts and carcinomas. The probability of malignancy on a breast lump increases with age.^[5] Factors like the woman’s age and physical characteristics of the mass, palpated by the clinician, may provide clues about its etiology on an initial assessment. However, a definitive diagnosis must be pursued, since all breast lumps warrant thorough evaluation.^[6] Every palpable mass, whose benign nature cannot be appropriately determined by ultrasound, will require biopsy for tissue diagnosis. This also applies to lesions that cannot be visualized by mammography. The role of the mammography in this setting is also to look for other coincident lesions that may not be palpated.^[7]

Causes In Female

Life Threatening Causes

There are no life-threatening causes.

Common Causes In Female

Causes In Female by Organ System

Cardiovascular	Angiosarcoma of the breast, Mondor's disease
Chemical/Poisoning	No underlying causes
Dental	No underlying causes
Dermatologic	Breast abscess,Cysts of Montgomery, epithelioma of the nipple, hives, intraductal papilloma, lymphocytoma cutis, Paget's disease of the breast, retroareolar cyst, sclerosing adenosis, sebaceous cyst, skin lumps, Zuska's disease
Drug Side Effect	Aldactone, aldomet (alphamethyldopa),alefacept, beta blockers, bicalutamide, casodex, chlorpromazine, cyclosporine, dalmane , digitalis, estazolam, etonogestrel, hormone replacement therapy, efalizumab, estradiol, estrogen, estrogen and progestin, etanercept, etonogestrel and ethinyl estradiol, flurazepam, flutamide, itraconazole, implanon, medroxyprogesterone, metoclopramide, norelgestromin and ethinyl estradiol, nilandron, nizoral, oral contraceptive pills,progestin
Ear Nose Throat	No underlying causes
Endocrine	Aberration of normal development and involution (ANDI), breast fibroadenoma, chronic cystic mastitis, fibro-adenosis of the newborn, fibroadenoma, galactocele, giant fibroadenoma, glandular thickening due to hormonal changes of pregnancy, hormone replacement therapy,hyalinized fibroadenoma, lactation, premenstrual syndrome, puberty, simple cyst
Environmental	No underlying causes
Gastroenterologic	No underlying causes
Genetic	Aberration of normal development and involution (ANDI), adenoid cystic carcinoma, apocrine metaplasia, apocrine or squamous metaplasia, apocrine papillary carcinoma, ataxia-telangiectasia heterozygosity, breast cancer, cancer, colloidal breast cancer, Cowden syndrome, cyclosporine, cyst wall cancer, ductal carcinoma, extramedullary myeloid tumor, giant mammary hamartoma, hamartoma, hereditary diffuse gastric cancer, Hodgkin's disease, inflammatory breast cancer, juvenile secretory carcinoma, Li-Fraumeni syndrome, lymphoma, malignant carcinoma, medullary carcinoma, metastatic breast cancer, metastatic cancer, mucinous carcinoma, Peutz-Jeghers syndrome, primary breast cancer, PTEN hamartoma tumor syndrome
Hematologic	Extramedullary myeloid tumor, Hodgkin's disease, lymphoma, medullary carcinoma, rhabdomyosarcoma, sarcoma, venous thrombosis
Iatrogenic	Abscess, alefacept, breast abscess, breast fat necrosis, breast implant, complicated cyst, cyclosporine, efalizumab, estradiol, estrogen, estrogen and progestin, etanercept, etonogestrel and ethinyl estradiol, hematoma, medroxyprogesterone, norelgestromin and ethinyl estradiol, postoperative scar/hematoma, progestin, radial scar, radiation induced angiosarcoma of the breast
Infectious Disease	Abscess, acute mastitis, benign inflammatory periductal mastitis, breast abscess, breast cyst, breast infection, tuberculosis of the breast
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	Ataxia-telangiectasia heterozygosity
Nutritional/Metabolic	ginseng
Obstetric/Gynecologic	Aberration of normal development and involution (ANDI), adenoid cystic carcinoma, apocrine metaplasia, apocrine or squamous metaplasia, apocrine papillary carcinoma, benign inflammatory periductal mastitis, breast abscess, breast cancer, breast duct papilloma, breast fat necrosis, breast fibroadenoma, breast implant, breast injury,breast trauma, chronic cystic mastitis, colloidal breast cancer, complicated cyst, cowden syndrome, cyst wall cancer, cystosarcoma phyllodes, cysts of Montgomery, duct ectasia of breast, ductal carcinoma, epithelioma of the nipple, fat necrosis, fibro-adeno-lipoma, fibro-adenosis of the newborn, fibroadenoma, galactocele, giant fibroadenoma, giant mammary hamartoma, glandular thickening due to hormonal changes of pregnancy, gynecomastia, hyalinized fibroadenoma, intraductal papilloma, lactation, Li-Fraumeni syndrome, lobular neoplasia, lymphocytic mastitis, mammary duct ectasia, mastitis, metastatic breast cancer, mucinous carcinoma, nipple conditions., paget's disease of the breast, periductal mastitis, phyllodes tumor, plasma cell mastitis, primary breast cancer, pseudoangiomatous stromal hyperplasia, retroareolar cyst, ruptured cyst or duct, sclerosing adenosis, tuberculosis of the breast, Zuska's disease
Oncologic	Adenoid cystic carcinoma, angiosarcoma of the breast, apocrine papillary carcinoma, ataxia-telangiectasia heterozygosity, benign breast disease, breast cancer, cancer, colloidal breast cancer, cyst wall cancer, cystosarcoma phyllodes, desmoplastic small round cell tumor, ductal carcinoma, epithelioma of the nipple, extramedullary myeloid tumor, hereditary diffuse gastric cancer, Hodgkin's disease, inflammatory breast cancer, juvenile secretory carcinoma, Li-Fraumeni syndrome, lymphoma, malignant carcinoma, medullary carcinoma, metastatic breast cancer, metastatic cancer, metastatic cancer, mucinous carcinoma, paget's disease of the breast, Peutz-Jeghers syndrome, phyllodes tumor, primary breast cancer, PTEN hamartoma tumor syndrome, radiation induced angiosarcoma of the breast, rhabdomyosarcoma, sarcoma, secretory breast carcinoma
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal/Electrolyte	No underlying causes
Rheumatology/Immunology/Allergy	Benign inflammatory periductal mastitis, cysts of Montgomery, desmoplastic small round cell tumor, hives, inflammatory breast cancer, intramammary lymph node, lymphatic obstruction, lymphocytoma cutis, lymphocytic mastitis, mastitis, Mondor's disease, periductal mastitis, plasma cell mastitis, Zuska's disease
Sexual	No underlying causes
Trauma	Breast fat necrosis, breast injury, breast trauma, blow on the breast, fat necrosis, hematoma, ruptured cyst or duct, traumatic fat necrosis,
Urologic	No underlying causes
Miscellaneous	Fibro-adeno-lipoma, hypertrophy, lipoma, lymphatic obstruction, oil cyst, postoperative scar/hematoma, radial scar, ruptured cyst or duct, venous thrombosis,

Causes In Female In Alphabetical Order

3

Causes In Males

Life-Threatening Causes

Common Causes In Male

Adipose tissue
Aging- more common in older men as male hormones reduce.
Breast abscess
Breast cancer
Hepatoma
Hyperthyroidism
Hypogonadism
Metastatic cancer
Neurofibroma
XXY males

Causes in Male by Organ System

Cardiovascular	Cantalamessa-baldini-ambrosi syndrome
Chemical/Poisoning	No underlying causes
Dental	No underlying causes
Dermatologic	Cantalamessa-baldini-ambrosi syndrome, gingival fibromatosis hypertrichosis, H syndrome, Pachydermoperiostosis ,
Drug Side Effect	Aldactone, bicalutamide, chloropromazine, cimetidine, flutamide, itraconazole, metoclopramide, nizoral
Ear Nose Throat	Gingival fibromatosis hypertrichosis, H syndrome, Retinitis pigmentosa, deafness, mental retardation, hypogonadism- syndrome
Endocrine	17-beta-hydroxysteroid dehydrogenase deficiency , Androgen insensitivity syndrome , Brugschs syndrome, Camera-marugo-cohen syndrome, Cantalamessa-baldini-ambrosi syndrome, Congenital adrenal hyperplasia 17-alpha-hydroxylase deficiency, 3-beta-hydroxysteroid dehydrogenase deficiency, Empty sella syndrome , Feminization, Forbes-Albright syndrome , luteinizing hormone releasing hormone deficiency, Gynecomastia, H syndrome, Hanhart syndrome, Heller-nelson syndrome, Hormone replacement therapy, Hyperprolactinemia, Klinefelter syndrome, Lactotroph adenoma, Newborn infant breast swelling, Obal syndrome, Partial androgen insensitivity, Primrose syndrome, pseudohermaphroditism male,Puberty, Salvioli syndrome, Sohval-Soffer syndrome, Summitt syndrome, Tang Hsi Ryu syndrome, Vasquez Hurst Sotos syndrome, Wilson turner syndrome, XX male syndrome, de la chapelle syndrome
Environmental	No underlying causes
Gastroenterologic	Cirrhosis of the liver, Hepatocellular carcinoma (fibrolamellar variant), Peutz-Jeghers syndrome, Tang Hsi Ryu syndrome
Genetic	17-beta-hydroxysteroid dehydrogenase deficiency, 46,XX testicular disorder of sex development, Androgen insensitivity syndrome , Brugschs syndrome, Congenital adrenal hyperplasia 17-alpha-hydroxylase deficiency, 3-beta-hydroxysteroid dehydrogenase deficiency, Fragile X syndrome, Klinefelter syndrome, Lesch-Nyhan's syndrome, Obal syndrome, Summitt syndrome, Tang Hsi Ryu syndrome, Vasquez Hurst Sotos syndrome, XX male syndrome, de la chapelle syndrome
Hematologic	No underlying causes
Iatrogenic	No underlying causes
Infectious Disease	Lymphatic filariasis,
Musculoskeletal/Orthopedic	Brugschs syndrome, Camera-marugo-cohen syndrome, Lesch-Nyhan's syndrome, Salvioli syndrome, Sohval-Soffer syndrome,Summitt syndrome
Neurologic	Camera-marugo-cohen syndrome, Fragile X syndrome,progressive spinobulbar muscular atrophy, Retinitis pigmentosa, deafness, mental retardation, hypogonadism, Sohval-Soffer syndrome, Spinal muscular atrophy, Summitt syndrome, Tang Hsi Ryu syndrome, Vasquez Hurst Sotos syndrome, wilson turner syndrome,
Nutritional/Metabolic	No underlying causes
Obstetric/Gynecologic	No underlying causes
Oncologic	Breast cancer
Ophthalmologic	Cantalamessa-baldini-ambrosi syndrome, Obal syndrome, Retinitis pigmentosa, deafness, mental retardation, hypogonadism.
Overdose/Toxicity	No underlying causes
Psychiatric	sexual arousal
Pulmonary	No underlying causes
Renal/Electrolyte	No underlying causes
Rheumatology/Immunology/Allergy	No underlying causes
Sexual	sexual arousal
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	No underlying causes

Causes in Male in Alphabetical order

3

Causes in Children

Neonates and infants^[8]
- Breast hypertrophy due to maternal hormones
Prepubertal and pubertal children^[9]^[10]
- Breast infection
- Hemangiomas and lymphangiomas
- Lipomastia
- Premature thelarche and thelarche
- Trauma

Causes in male Adolescents

Breast enlargement in male adolescents is defined as gynecomastia:^[11]
- Persistent pubertal gynecomastia
- Drugs such as spironolactone,cimetidine,ketoconozale,recombinant human growth hormone, estrogens, antiandrogens, gonadotropin-releasing hormone (GnRH) agonists, 5-alpha-reductase inhibitors and human chorionic gonadotropin (hCG)^[12]
- Idiopathic
- Cirrohsis
- Malnutrition
- Hyperthyroidism
- Hypogonadism
- Testicular tumors
- Chronic renal insufficiency

Causes in Female Adolescents

Fibrocystic change^[13]
Juvenille fibroadenoma^[14]
Giant fibroadenoma

References

↑ Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson.; Robbins, Stanley L. (Stanley Leonard); Cotran, Ramzi S. (2005). Robbins and Cotran pathologic basis of disea. Philadelphia: Elsevier Saunders. ISBN 978-0-7216-0187-8.
↑ Andreoli, Thomas E.; Cecil, Russell L. (Russell La Fayette) (2010). Andreoli and Carpenter's Cecil essentials of medicin. Philadelphia, PA: Saunders/Elsevier. ISBN 978-1-4160-6109-0.
↑ Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson.; Robbins, Stanley L. (Stanley Leonard); Cotran, Ramzi S. (2005). Robbins and Cotran pathologic basis of disea. Philadelphia: Elsevier Saunders. ISBN 978-0-7216-0187-8.
↑ Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson.; Robbins, Stanley L. (Stanley Leonard); Cotran, Ramzi S. (2005). Robbins and Cotran pathologic basis of disea. Philadelphia: Elsevier Saunders. ISBN 978-0-7216-0187-8.
↑ Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson.; Robbins, Stanley L. (Stanley Leonard); Cotran, Ramzi S. (2005). Robbins and Cotran pathologic basis of disea. Philadelphia: Elsevier Saunders. ISBN 978-0-7216-0187-8.
↑ Bickley, Lynn S.; Szilagyi, Peter G.; Bates, Barbara (2009). Bates' guide to physical examination and history taki. Philadelphia: Wolters Kluwer Health/Lippincott Williams Wilkins. ISBN 0-7817-8058-6.
↑ Andreoli, Thomas E.; Cecil, Russell L. (Russell La Fayette) (2010). Andreoli and Carpenter's Cecil essentials of medicin. Philadelphia, PA: Saunders/Elsevier. ISBN 978-1-4160-6109-0.
↑ Greydanus DE, Matytsina L, Gains M (2006). "Breast disorders in children and adolescents". Prim Care. 33 (2): 455–502. doi:10.1016/j.pop.2006.02.002. PMID 16713771.
↑ Kaplowitz P, Bloch C, Section on Endocrinology, American Academy of Pediatrics (2016). "Evaluation and Referral of Children With Signs of Early Puberty". Pediatrics. 137 (1). doi:10.1542/peds.2015-3732. PMID 26668298.
↑ De Silva NK, Brandt ML (2006). "Disorders of the breast in children and adolescents, Part 2: breast masses". J Pediatr Adolesc Gynecol. 19 (6): 415–8. doi:10.1016/j.jpag.2006.09.002. PMID 17174833.
↑ Braunstein GD (2007). "Clinical practice. Gynecomastia". N Engl J Med. 357 (12): 1229–37. doi:10.1056/NEJMcp070677. PMID 17881754.
↑ Deepinder F, Braunstein GD (2012). "Drug-induced gynecomastia: an evidence-based review". Expert Opin Drug Saf. 11 (5): 779–95. doi:10.1517/14740338.2012.712109. PMID 22862307.
↑ Templeman C, Hertweck SP (2000). "Breast disorders in the pediatric and adolescent patient". Obstet Gynecol Clin North Am. 27 (1): 19–34. PMID 10693180.
↑ Sanders LM, Sharma P, El Madany M, King AB, Goodman KS, Sanders AE (2018). "Clinical breast concerns in low-risk pediatric patients: practice review with proposed recommendations". Pediatr Radiol. 48 (2): 186–195. doi:10.1007/s00247-017-4007-6. PMID 29080125.

Template:WikiDoc Sources

[1] Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson.; Robbins, Stanley L. (Stanley Leonard); Cotran, Ramzi S. (2005). Robbins and Cotran pathologic basis of disea. Philadelphia: Elsevier Saunders. ISBN 978-0-7216-0187-8.

[2] Andreoli, Thomas E.; Cecil, Russell L. (Russell La Fayette) (2010). Andreoli and Carpenter's Cecil essentials of medicin. Philadelphia, PA: Saunders/Elsevier. ISBN 978-1-4160-6109-0.

[3] Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson.; Robbins, Stanley L. (Stanley Leonard); Cotran, Ramzi S. (2005). Robbins and Cotran pathologic basis of disea. Philadelphia: Elsevier Saunders. ISBN 978-0-7216-0187-8.

[4] Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson.; Robbins, Stanley L. (Stanley Leonard); Cotran, Ramzi S. (2005). Robbins and Cotran pathologic basis of disea. Philadelphia: Elsevier Saunders. ISBN 978-0-7216-0187-8.

[5] Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson.; Robbins, Stanley L. (Stanley Leonard); Cotran, Ramzi S. (2005). Robbins and Cotran pathologic basis of disea. Philadelphia: Elsevier Saunders. ISBN 978-0-7216-0187-8.

[6] Bickley, Lynn S.; Szilagyi, Peter G.; Bates, Barbara (2009). Bates' guide to physical examination and history taki. Philadelphia: Wolters Kluwer Health/Lippincott Williams Wilkins. ISBN 0-7817-8058-6.

[7] Andreoli, Thomas E.; Cecil, Russell L. (Russell La Fayette) (2010). Andreoli and Carpenter's Cecil essentials of medicin. Philadelphia, PA: Saunders/Elsevier. ISBN 978-1-4160-6109-0.

[pmid16713771-8] Greydanus DE, Matytsina L, Gains M (2006). "Breast disorders in children and adolescents". Prim Care. 33 (2): 455–502. doi:10.1016/j.pop.2006.02.002. PMID 16713771.

[pmid26668298-9] Kaplowitz P, Bloch C, Section on Endocrinology, American Academy of Pediatrics (2016). "Evaluation and Referral of Children With Signs of Early Puberty". Pediatrics. 137 (1). doi:10.1542/peds.2015-3732. PMID 26668298.

[pmid17174833-10] De Silva NK, Brandt ML (2006). "Disorders of the breast in children and adolescents, Part 2: breast masses". J Pediatr Adolesc Gynecol. 19 (6): 415–8. doi:10.1016/j.jpag.2006.09.002. PMID 17174833.

[pmid17881754-11] Braunstein GD (2007). "Clinical practice. Gynecomastia". N Engl J Med. 357 (12): 1229–37. doi:10.1056/NEJMcp070677. PMID 17881754.

[pmid22862307-12] Deepinder F, Braunstein GD (2012). "Drug-induced gynecomastia: an evidence-based review". Expert Opin Drug Saf. 11 (5): 779–95. doi:10.1517/14740338.2012.712109. PMID 22862307.

[pmid10693180-13] Templeman C, Hertweck SP (2000). "Breast disorders in the pediatric and adolescent patient". Obstet Gynecol Clin North Am. 27 (1): 19–34. PMID 10693180.

[pmid29080125-14] Sanders LM, Sharma P, El Madany M, King AB, Goodman KS, Sanders AE (2018). "Clinical breast concerns in low-risk pediatric patients: practice review with proposed recommendations". Pediatr Radiol. 48 (2): 186–195. doi:10.1007/s00247-017-4007-6. PMID 29080125.

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@@ Line 38: / Line 38: @@
 ===Causes In Female by Organ System===
-{|style="width:80%; height:100px" border="1"
+{| style="width:80%; height:100px" border="1"
-|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
+| style="width:25%" bgcolor="LightSteelBlue" ; border="1" |'''Cardiovascular'''
-|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[hemangiosarcoma|Angiosarcoma of the breast]], [[Mondor's disease]]
+| style="width:75%" bgcolor="Beige" ; border="1" | [[hemangiosarcoma|Angiosarcoma of the breast]], [[Mondor's disease]]
 |-
-|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
+| bgcolor="LightSteelBlue" | '''Chemical/Poisoning'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Dental'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Dermatologic'''
-|bgcolor="Beige"|[[Breast abscess]],[[Glands of Montgomery|Cysts of Montgomery]], [[epithelioma|epithelioma of the nipple]], [[hives]], [[intraductal papilloma]], [[pseudolymphoma|lymphocytoma cutis]], [[Paget's disease of the breast]], [[breast cyst|retroareolar cyst]], [[sclerosis|sclerosing adenosis]], [[sebaceous cyst]], [[skin|skin lumps]], [[Zuska's disease]]
+| bgcolor="Beige" |[[Breast abscess]],[[Glands of Montgomery|Cysts of Montgomery]], [[epithelioma|epithelioma of the nipple]], [[hives]], [[intraductal papilloma]], [[pseudolymphoma|lymphocytoma cutis]], [[Paget's disease of the breast]], [[breast cyst|retroareolar cyst]], [[sclerosis|sclerosing adenosis]], [[sebaceous cyst]], [[skin|skin lumps]], [[Zuska's disease]]
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Drug Side Effect'''
-|bgcolor="Beige"| [[Aldactone]], [[aldomet]] (alphamethyldopa),[[alefacept]], [[beta blockers]], [[bicalutamide]], [[casodex]], [[chlorpromazine]], [[cyclosporine]], [[dalmane]] , [[digitalis]], [[estazolam]], [[etonogestrel]], [[hormone replacement therapy]], [[efalizumab]], [[estradiol]], [[estrogen]], [[birth control|estrogen and progestin]], [[etanercept]], [[birth control|etonogestrel and ethinyl estradiol]], [[flurazepam]], [[flutamide]], [[itraconazole]], [[implanon]], [[medroxyprogesterone]], [[metoclopramide]], [[birth control|norelgestromin and ethinyl estradiol]], [[nilandron]], [[nizoral]], [[oral contraceptive pills]],[[progestin]]
+| bgcolor="Beige" | [[Aldactone]], [[aldomet]] (alphamethyldopa),[[alefacept]], [[beta blockers]], [[bicalutamide]], [[casodex]], [[chlorpromazine]], [[cyclosporine]], [[dalmane]] , [[digitalis]], [[estazolam]], [[etonogestrel]], [[hormone replacement therapy]], [[efalizumab]], [[estradiol]], [[estrogen]], [[birth control|estrogen and progestin]], [[etanercept]], [[birth control|etonogestrel and ethinyl estradiol]], [[flurazepam]], [[flutamide]], [[itraconazole]], [[implanon]], [[medroxyprogesterone]], [[metoclopramide]], [[birth control|norelgestromin and ethinyl estradiol]], [[nilandron]], [[nizoral]], [[oral contraceptive pills]],[[progestin]]
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Ear Nose Throat'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Endocrine'''
-|bgcolor="Beige"| [[Breast|Aberration of normal development and involution (ANDI)]], [[fibroadenoma|breast fibroadenoma]], [[chronic cystic mastitis]], [[fibroadenoma|fibro-adenosis of the newborn]], [[fibroadenoma]], [[galactocele]], [[fibroadenoma|giant fibroadenoma]],  [[pregnancy|glandular thickening due to hormonal changes of pregnancy]], [[hormone replacement therapy]],[[fibroadenoma|hyalinized fibroadenoma]], [[lactation]], [[premenstrual syndrome]], [[puberty]], [[breast cyst|simple cyst]]
+| bgcolor="Beige" | [[Breast|Aberration of normal development and involution (ANDI)]], [[fibroadenoma|breast fibroadenoma]], [[chronic cystic mastitis]], [[fibroadenoma|fibro-adenosis of the newborn]], [[fibroadenoma]], [[galactocele]], [[fibroadenoma|giant fibroadenoma]],  [[pregnancy|glandular thickening due to hormonal changes of pregnancy]], [[hormone replacement therapy]],[[fibroadenoma|hyalinized fibroadenoma]], [[lactation]], [[premenstrual syndrome]], [[puberty]], [[breast cyst|simple cyst]]
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Environmental'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Gastroenterologic'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Genetic'''
-|bgcolor="Beige"| [[Breast|Aberration of normal development and involution (ANDI)]], [[adenoid cystic carcinoma]], [[metaplasia|apocrine metaplasia]], [[metaplasia|apocrine or squamous metaplasia]], [[papillary carcinoma of the breast|apocrine papillary carcinoma]], [[telangiectasia|ataxia-telangiectasia heterozygosity]], [[breast cancer]], [[cancer]], [[breast cancer|colloidal breast cancer]], [[Cowden syndrome]], [[cyclosporine]], [[breast cancer|cyst wall cancer]], [[ductal carcinoma]], [[extramedullary myeloid tumor]], [[hamartoma|giant mammary hamartoma]], [[hamartoma]], [[stomach cancer|hereditary diffuse gastric cancer]], [[Hodgkin's disease]], [[inflammatory breast cancer]], [[breast cancer|juvenile secretory carcinoma]], [[Li-Fraumeni syndrome]], [[lymphoma]], [[carcinoma|malignant carcinoma]], [[medullary carcinoma]], [[breast cancer|metastatic breast cancer]], [[metastatic cancer]], [[breast cancer|mucinous carcinoma]], [[Peutz-Jeghers syndrome]], [[breast cancer|primary breast cancer]], [[multiple hamartoma syndrome|PTEN hamartoma tumor syndrome]]
+| bgcolor="Beige" | [[Breast|Aberration of normal development and involution (ANDI)]], [[adenoid cystic carcinoma]], [[metaplasia|apocrine metaplasia]], [[metaplasia|apocrine or squamous metaplasia]], [[papillary carcinoma of the breast|apocrine papillary carcinoma]], [[telangiectasia|ataxia-telangiectasia heterozygosity]], [[breast cancer]], [[cancer]], [[breast cancer|colloidal breast cancer]], [[Cowden syndrome]], [[cyclosporine]], [[breast cancer|cyst wall cancer]], [[ductal carcinoma]], [[extramedullary myeloid tumor]], [[hamartoma|giant mammary hamartoma]], [[hamartoma]], [[stomach cancer|hereditary diffuse gastric cancer]], [[Hodgkin's disease]], [[inflammatory breast cancer]], [[breast cancer|juvenile secretory carcinoma]], [[Li-Fraumeni syndrome]], [[lymphoma]], [[carcinoma|malignant carcinoma]], [[medullary carcinoma]], [[breast cancer|metastatic breast cancer]], [[metastatic cancer]], [[breast cancer|mucinous carcinoma]], [[Peutz-Jeghers syndrome]], [[breast cancer|primary breast cancer]], [[multiple hamartoma syndrome|PTEN hamartoma tumor syndrome]]
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Hematologic'''
-|bgcolor="Beige"| [[Extramedullary myeloid tumor]], [[Hodgkin's disease]], [[lymphoma]], [[medullary carcinoma]], [[rhabdomyosarcoma]], [[sarcoma]], [[venous thrombosis]]
+| bgcolor="Beige" | [[Extramedullary myeloid tumor]], [[Hodgkin's disease]], [[lymphoma]], [[medullary carcinoma]], [[rhabdomyosarcoma]], [[sarcoma]], [[venous thrombosis]]
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Iatrogenic'''
-|bgcolor="Beige"| [[Abscess]], [[alefacept]], [[breast abscess]], [[fat necrosis|breast fat necrosis]], [[breast implant]], [[breast cyst|complicated cyst]], [[cyclosporine]], [[efalizumab]], [[estradiol]], [[estrogen]], [[birth control|estrogen and progestin]], [[etanercept]], [[birth control|etonogestrel and ethinyl estradiol]], [[hematoma]], [[medroxyprogesterone]], [[birth control|norelgestromin and ethinyl estradiol]], [[iatrogenesis|postoperative scar/hematoma]], [[progestin]], [[sclerosis|radial scar]], [[hemangiosarcoma|radiation induced angiosarcoma of the breast]]
+| bgcolor="Beige" | [[Abscess]], [[alefacept]], [[breast abscess]], [[fat necrosis|breast fat necrosis]], [[breast implant]], [[breast cyst|complicated cyst]], [[cyclosporine]], [[efalizumab]], [[estradiol]], [[estrogen]], [[birth control|estrogen and progestin]], [[etanercept]], [[birth control|etonogestrel and ethinyl estradiol]], [[hematoma]], [[medroxyprogesterone]], [[birth control|norelgestromin and ethinyl estradiol]], [[iatrogenesis|postoperative scar/hematoma]], [[progestin]], [[sclerosis|radial scar]], [[hemangiosarcoma|radiation induced angiosarcoma of the breast]]
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Infectious Disease'''
-|bgcolor="Beige"| [[Abscess]], [[mastitis|acute mastitis]], [[mastitis|benign inflammatory periductal mastitis]], [[breast abscess]], [[breast cyst]], [[breast infection]], [[tuberculosis|tuberculosis of the breast]]
+| bgcolor="Beige" | [[Abscess]], [[mastitis|acute mastitis]], [[mastitis|benign inflammatory periductal mastitis]], [[breast abscess]], [[breast cyst]], [[breast infection]], [[tuberculosis|tuberculosis of the breast]]
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Musculoskeletal/Orthopedic'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Neurologic'''
-|bgcolor="Beige"| [[Telangiectasia|Ataxia-telangiectasia heterozygosity]]
+| bgcolor="Beige" | [[Telangiectasia|Ataxia-telangiectasia heterozygosity]]
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Nutritional/Metabolic'''
-|bgcolor="Beige"| [[ginseng]]
+| bgcolor="Beige" | [[ginseng]]
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Obstetric/Gynecologic'''
-|bgcolor="Beige"| [[Breast|Aberration of normal development and involution (ANDI)]], [[adenoid cystic carcinoma]], [[metaplasia|apocrine metaplasia]], [[metaplasia|apocrine or squamous metaplasia]], [[papillary carcinoma of the breast|apocrine papillary carcinoma]], [[mastitis|benign inflammatory periductal mastitis]], [[breast abscess]], [[breast cancer]], [[papilloma|breast duct papilloma]], [[fat necrosis|breast fat necrosis]], [[fibroadenoma|breast fibroadenoma]], [[breast implant]], [[physical trauma|breast injury]],[[physical trauma|breast trauma]], [[chronic cystic mastitis]], [[breast cancer|colloidal breast cancer]], [[breast cyst|complicated cyst]], [[cowden syndrome]], [[breast cancer|cyst wall cancer]], [[cystosarcoma phyllodes]], [[glands of Montgomery|cysts of Montgomery]], [[duct ectasia of breast]], [[ductal carcinoma]], [[epithelioma|epithelioma of the nipple]], [[fat necrosis]], [[hamartoma|fibro-adeno-lipoma]], [[fibroadenoma|fibro-adenosis of the newborn]], [[fibroadenoma]], [[galactocele]], [[fibroadenoma|giant fibroadenoma]], [[hamartoma|giant mammary hamartoma]], [[pregnancy|glandular thickening due to hormonal changes of pregnancy]], [[gynecomastia]], [[fibroadenoma|hyalinized fibroadenoma]], [[intraductal papilloma]], [[lactation]], [[Li-Fraumeni syndrome]], [[breast cancer|lobular neoplasia]], [[mastitis|lymphocytic mastitis]], [[mammary duct ectasia]], [[mastitis]], [[breast cancer|metastatic breast cancer]], [[breast cancer|mucinous carcinoma]], [[mastalgia|nipple conditions]]., [[paget's disease of the breast]], [[mastitis|periductal mastitis]], [[phyllodes tumor]], [[mastitis|plasma cell mastitis]], [[breast cancer|primary breast cancer]], [[hyperplasia|pseudoangiomatous stromal hyperplasia]], [[breast cyst|retroareolar cyst]], [[breast cyst|ruptured cyst or duct]], [[sclerosis|sclerosing adenosis]], [[tuberculosis|tuberculosis of the breast]], [[Zuska's disease]]
+| bgcolor="Beige" | [[Breast|Aberration of normal development and involution (ANDI)]], [[adenoid cystic carcinoma]], [[metaplasia|apocrine metaplasia]], [[metaplasia|apocrine or squamous metaplasia]], [[papillary carcinoma of the breast|apocrine papillary carcinoma]], [[mastitis|benign inflammatory periductal mastitis]], [[breast abscess]], [[breast cancer]], [[papilloma|breast duct papilloma]], [[fat necrosis|breast fat necrosis]], [[fibroadenoma|breast fibroadenoma]], [[breast implant]], [[physical trauma|breast injury]],[[physical trauma|breast trauma]], [[chronic cystic mastitis]], [[breast cancer|colloidal breast cancer]], [[breast cyst|complicated cyst]], [[cowden syndrome]], [[breast cancer|cyst wall cancer]], [[cystosarcoma phyllodes]], [[glands of Montgomery|cysts of Montgomery]], [[duct ectasia of breast]], [[ductal carcinoma]], [[epithelioma|epithelioma of the nipple]], [[fat necrosis]], [[hamartoma|fibro-adeno-lipoma]], [[fibroadenoma|fibro-adenosis of the newborn]], [[fibroadenoma]], [[galactocele]], [[fibroadenoma|giant fibroadenoma]], [[hamartoma|giant mammary hamartoma]], [[pregnancy|glandular thickening due to hormonal changes of pregnancy]], [[gynecomastia]], [[fibroadenoma|hyalinized fibroadenoma]], [[intraductal papilloma]], [[lactation]], [[Li-Fraumeni syndrome]], [[breast cancer|lobular neoplasia]], [[mastitis|lymphocytic mastitis]], [[mammary duct ectasia]], [[mastitis]], [[breast cancer|metastatic breast cancer]], [[breast cancer|mucinous carcinoma]], [[mastalgia|nipple conditions]]., [[paget's disease of the breast]], [[mastitis|periductal mastitis]], [[phyllodes tumor]], [[mastitis|plasma cell mastitis]], [[breast cancer|primary breast cancer]], [[hyperplasia|pseudoangiomatous stromal hyperplasia]], [[breast cyst|retroareolar cyst]], [[breast cyst|ruptured cyst or duct]], [[sclerosis|sclerosing adenosis]], [[tuberculosis|tuberculosis of the breast]], [[Zuska's disease]]
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Oncologic'''
-|bgcolor="Beige"| [[Adenoid cystic carcinoma]], [[hemangiosarcoma|angiosarcoma of the breast]], [[papillary carcinoma of the breast|apocrine papillary carcinoma]], [[telangiectasia|ataxia-telangiectasia heterozygosity]], [[breast cancer|benign breast disease]], [[breast cancer]], [[cancer]], [[breast cancer|colloidal breast cancer]], [[breast cancer|cyst wall cancer]], [[cystosarcoma phyllodes]], [[desmoplastic small round cell tumor]], [[ductal carcinoma]], [[epithelioma|epithelioma of the nipple]], [[extramedullary myeloid tumor]], [[stomach cancer|hereditary diffuse gastric cancer]], [[Hodgkin's disease]], [[inflammatory breast cancer]], [[breast cancer|juvenile secretory carcinoma]], [[Li-Fraumeni syndrome]], [[lymphoma]], [[carcinoma|malignant carcinoma]], [[medullary carcinoma]], [[breast cancer|metastatic breast cancer]], [[metastatic cancer]], [[metastatic cancer]], [[breast cancer|mucinous carcinoma]], [[paget's disease of the breast]], [[Peutz-Jeghers syndrome]], [[phyllodes tumor]], [[breast cancer|primary breast cancer]], [[multiple hamartoma syndrome|PTEN hamartoma tumor syndrome]], [[hemangiosarcoma|radiation induced angiosarcoma of the breast]], [[rhabdomyosarcoma]], [[sarcoma]], [[breast cancer|secretory breast carcinoma]]
+| bgcolor="Beige" | [[Adenoid cystic carcinoma]], [[hemangiosarcoma|angiosarcoma of the breast]], [[papillary carcinoma of the breast|apocrine papillary carcinoma]], [[telangiectasia|ataxia-telangiectasia heterozygosity]], [[breast cancer|benign breast disease]], [[breast cancer]], [[cancer]], [[breast cancer|colloidal breast cancer]], [[breast cancer|cyst wall cancer]], [[cystosarcoma phyllodes]], [[desmoplastic small round cell tumor]], [[ductal carcinoma]], [[epithelioma|epithelioma of the nipple]], [[extramedullary myeloid tumor]], [[stomach cancer|hereditary diffuse gastric cancer]], [[Hodgkin's disease]], [[inflammatory breast cancer]], [[breast cancer|juvenile secretory carcinoma]], [[Li-Fraumeni syndrome]], [[lymphoma]], [[carcinoma|malignant carcinoma]], [[medullary carcinoma]], [[breast cancer|metastatic breast cancer]], [[metastatic cancer]], [[metastatic cancer]], [[breast cancer|mucinous carcinoma]], [[paget's disease of the breast]], [[Peutz-Jeghers syndrome]], [[phyllodes tumor]], [[breast cancer|primary breast cancer]], [[multiple hamartoma syndrome|PTEN hamartoma tumor syndrome]], [[hemangiosarcoma|radiation induced angiosarcoma of the breast]], [[rhabdomyosarcoma]], [[sarcoma]], [[breast cancer|secretory breast carcinoma]]
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Ophthalmologic'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Overdose/Toxicity'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Psychiatric'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Pulmonary'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Renal/Electrolyte'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Rheumatology/Immunology/Allergy'''
-|bgcolor="Beige"| [[Mastitis|Benign inflammatory periductal mastitis]], [[glands of Montgomery|cysts of Montgomery]], [[desmoplastic small round cell tumor]], [[hives]], [[inflammatory breast cancer]], [[lymph node|intramammary lymph node]], [[lymphatic obstruction]], [[pseudolymphoma|lymphocytoma cutis]], [[mastitis|lymphocytic mastitis]], [[mastitis]], [[Mondor's disease]], [[mastitis|periductal mastitis]], [[mastitis|plasma cell mastitis]], [[Zuska's disease]]
+| bgcolor="Beige" | [[Mastitis|Benign inflammatory periductal mastitis]], [[glands of Montgomery|cysts of Montgomery]], [[desmoplastic small round cell tumor]], [[hives]], [[inflammatory breast cancer]], [[lymph node|intramammary lymph node]], [[lymphatic obstruction]], [[pseudolymphoma|lymphocytoma cutis]], [[mastitis|lymphocytic mastitis]], [[mastitis]], [[Mondor's disease]], [[mastitis|periductal mastitis]], [[mastitis|plasma cell mastitis]], [[Zuska's disease]]
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Sexual'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Trauma'''
-|bgcolor="Beige"| [[Fat necrosis|Breast fat necrosis]], [[physical trauma|breast injury]], [[physical trauma|breast trauma]], [[physical trauma|blow on the breast]], [[fat necrosis]], [[hematoma]], [[breast cyst|ruptured cyst or duct]], [[fat necrosis|traumatic fat necrosis]],
+| bgcolor="Beige" | [[Fat necrosis|Breast fat necrosis]], [[physical trauma|breast injury]], [[physical trauma|breast trauma]], [[physical trauma|blow on the breast]], [[fat necrosis]], [[hematoma]], [[breast cyst|ruptured cyst or duct]], [[fat necrosis|traumatic fat necrosis]],
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Urologic'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Miscellaneous'''
-|bgcolor="Beige"|[[Hamartoma|Fibro-adeno-lipoma]], [[hypertrophy]], [[lipoma]], [[lymphatic obstruction]], [[breast cyst|oil cyst]], [[iatrogenesis|postoperative scar/hematoma]], [[sclerosis|radial scar]], [[breast cyst|ruptured cyst or duct]], [[venous thrombosis]],
+| bgcolor="Beige" |[[Hamartoma|Fibro-adeno-lipoma]], [[hypertrophy]], [[lipoma]], [[lymphatic obstruction]], [[breast cyst|oil cyst]], [[iatrogenesis|postoperative scar/hematoma]], [[sclerosis|radial scar]], [[breast cyst|ruptured cyst or duct]], [[venous thrombosis]],
 |-
 |}
@@ Line 308: / Line 308: @@
 ===Causes in Male by Organ System===
-{|style="width:80%; height:100px" border="1"
+{| style="width:80%; height:100px" border="1"
-|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
+| style="width:25%" bgcolor="LightSteelBlue" ; border="1" |'''Cardiovascular'''
-|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | Cantalamessa-baldini-ambrosi syndrome
+| style="width:75%" bgcolor="Beige" ; border="1" | Cantalamessa-baldini-ambrosi syndrome
 |-
-|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
+| bgcolor="LightSteelBlue" | '''Chemical/Poisoning'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Dental'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Dermatologic'''
-|bgcolor="Beige"| Cantalamessa-baldini-ambrosi syndrome, gingival fibromatosis hypertrichosis, H syndrome, [[Pachydermoperiostosis ]],
+| bgcolor="Beige" | Cantalamessa-baldini-ambrosi syndrome, gingival fibromatosis hypertrichosis, H syndrome, [[Pachydermoperiostosis ]] ,
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Drug Side Effect'''
-|bgcolor="Beige"| [[Aldactone]], [[bicalutamide]], [[chloropromazine]], [[cimetidine]], [[flutamide]], [[itraconazole]], [[metoclopramide]], [[nizoral]]
+| bgcolor="Beige" | [[Aldactone]], [[bicalutamide]], [[chloropromazine]], [[cimetidine]], [[flutamide]], [[itraconazole]], [[metoclopramide]], [[nizoral]]
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Ear Nose Throat'''
-|bgcolor="Beige"| Gingival fibromatosis hypertrichosis, H syndrome, Retinitis pigmentosa, deafness, mental retardation, hypogonadism- syndrome
+| bgcolor="Beige" | Gingival fibromatosis hypertrichosis, H syndrome, Retinitis pigmentosa, deafness, mental retardation, hypogonadism- syndrome
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Endocrine'''
-|bgcolor="Beige"| [[17-beta-hydroxysteroid dehydrogenase deficiency ]], [[Androgen insensitivity syndrome ]], Brugschs syndrome,  Camera-marugo-cohen syndrome, Cantalamessa-baldini-ambrosi syndrome, [[Congenital adrenal hyperplasia]] 17-alpha-hydroxylase deficiency, [[Congenital adrenal hyperplasia due to 3 beta-hydroxysteroid dehydrogenase deficiency|3-beta-hydroxysteroid dehydrogenase deficiency]], [[Empty sella syndrome ]], [[Feminization]], [[Forbes-Albright syndrome]] , [[Gonadotropin-releasing hormone deficiency|luteinizing hormone releasing hormone deficiency]],    [[Gynecomastia]], H syndrome, [[Hanhart syndrome]], Heller-nelson syndrome, [[Hormone replacement therapy]], [[Hyperprolactinemia]], [[Klinefelter syndrome]], [[Lactotroph adenoma]], Newborn infant breast swelling, Obal syndrome, [[Partial androgen insensitivity]], [[Primrose syndrome]], [[Pseudohermaphroditism|pseudohermaphroditism male]],[[Puberty]], Salvioli syndrome, [[Sohval-Soffer syndrome]], [[Summitt syndrome]], [[Tang Hsi Ryu syndrome]], [[Vasquez Hurst Sotos syndrome]], [[Wilson-Turner X-linked mental retardation syndrome|Wilson turner syndrome]], [[XX male syndrome]], [[XX male syndrome|de la chapelle syndrome]]
+| bgcolor="Beige" | [[17-beta-hydroxysteroid dehydrogenase deficiency ]] , [[Androgen insensitivity syndrome ]] , Brugschs syndrome,  Camera-marugo-cohen syndrome, Cantalamessa-baldini-ambrosi syndrome, [[Congenital adrenal hyperplasia]] 17-alpha-hydroxylase deficiency, [[Congenital adrenal hyperplasia due to 3 beta-hydroxysteroid dehydrogenase deficiency|3-beta-hydroxysteroid dehydrogenase deficiency]], [[Empty sella syndrome ]] , [[Feminization]], [[Forbes-Albright syndrome]] , [[Gonadotropin-releasing hormone deficiency|luteinizing hormone releasing hormone deficiency]],    [[Gynecomastia]], H syndrome, [[Hanhart syndrome]], Heller-nelson syndrome, [[Hormone replacement therapy]], [[Hyperprolactinemia]], [[Klinefelter syndrome]], [[Lactotroph adenoma]], Newborn infant breast swelling, Obal syndrome, [[Partial androgen insensitivity]], [[Primrose syndrome]], [[Pseudohermaphroditism|pseudohermaphroditism male]],[[Puberty]], Salvioli syndrome, [[Sohval-Soffer syndrome]], [[Summitt syndrome]], [[Tang Hsi Ryu syndrome]], [[Vasquez Hurst Sotos syndrome]], [[Wilson-Turner X-linked mental retardation syndrome|Wilson turner syndrome]], [[XX male syndrome]], [[XX male syndrome|de la chapelle syndrome]]
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Environmental'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Gastroenterologic'''
-|bgcolor="Beige"| [[Cirrhosis of the liver]], [[Hepatocellular carcinoma]] (fibrolamellar variant), [[Peutz-Jeghers syndrome]], [[Tang Hsi Ryu syndrome]]
+| bgcolor="Beige" | [[Cirrhosis of the liver]], [[Hepatocellular carcinoma]] (fibrolamellar variant), [[Peutz-Jeghers syndrome]], [[Tang Hsi Ryu syndrome]]
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Genetic'''
-|bgcolor="Beige"| [[17-beta-hydroxysteroid dehydrogenase deficiency]], 46,XX testicular disorder of sex development, [[Androgen insensitivity syndrome ]], Brugschs syndrome, [[Congenital adrenal hyperplasia]] 17-alpha-hydroxylase deficiency, [[Congenital adrenal hyperplasia due to 3 beta-hydroxysteroid dehydrogenase deficiency|3-beta-hydroxysteroid dehydrogenase deficiency]], [[Fragile X syndrome]], [[Klinefelter syndrome]], [[Lesch-Nyhan's syndrome]], Obal syndrome, [[Summitt syndrome]], [[Tang Hsi Ryu syndrome]], [[Vasquez Hurst Sotos syndrome]], [[XX male syndrome]], [[XX male syndrome|de la chapelle syndrome]]
+| bgcolor="Beige" | [[17-beta-hydroxysteroid dehydrogenase deficiency]], 46,XX testicular disorder of sex development, [[Androgen insensitivity syndrome ]] , Brugschs syndrome, [[Congenital adrenal hyperplasia]] 17-alpha-hydroxylase deficiency, [[Congenital adrenal hyperplasia due to 3 beta-hydroxysteroid dehydrogenase deficiency|3-beta-hydroxysteroid dehydrogenase deficiency]], [[Fragile X syndrome]], [[Klinefelter syndrome]], [[Lesch-Nyhan's syndrome]], Obal syndrome, [[Summitt syndrome]], [[Tang Hsi Ryu syndrome]], [[Vasquez Hurst Sotos syndrome]], [[XX male syndrome]], [[XX male syndrome|de la chapelle syndrome]]
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Hematologic'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Iatrogenic'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Infectious Disease'''
-|bgcolor="Beige"|[[Lymphatic filariasis]],
+| bgcolor="Beige" |[[Lymphatic filariasis]],
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Musculoskeletal/Orthopedic'''
-|bgcolor="Beige"| Brugschs syndrome, Camera-marugo-cohen syndrome, [[Lesch-Nyhan's syndrome]], Salvioli syndrome, [[Sohval-Soffer syndrome]],[[Summitt syndrome]]
+| bgcolor="Beige" | Brugschs syndrome, Camera-marugo-cohen syndrome, [[Lesch-Nyhan's syndrome]], Salvioli syndrome, [[Sohval-Soffer syndrome]],[[Summitt syndrome]]
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Neurologic'''
-|bgcolor="Beige"| Camera-marugo-cohen syndrome, [[Fragile X syndrome]],[[Kennedy disease|progressive spinobulbar muscular atrophy]], Retinitis pigmentosa, deafness, mental retardation, hypogonadism, [[Sohval-Soffer syndrome]], [[Spinal muscular atrophy]], [[Summitt syndrome]], [[Tang Hsi Ryu syndrome]], [[Vasquez Hurst Sotos syndrome]], [[Wilson-turner X-linked mental retardation syndrome|wilson turner syndrome]],
+| bgcolor="Beige" | Camera-marugo-cohen syndrome, [[Fragile X syndrome]],[[Kennedy disease|progressive spinobulbar muscular atrophy]], Retinitis pigmentosa, deafness, mental retardation, hypogonadism, [[Sohval-Soffer syndrome]], [[Spinal muscular atrophy]], [[Summitt syndrome]], [[Tang Hsi Ryu syndrome]], [[Vasquez Hurst Sotos syndrome]], [[Wilson-turner X-linked mental retardation syndrome|wilson turner syndrome]],
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Nutritional/Metabolic'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Obstetric/Gynecologic'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Oncologic'''
-|bgcolor="Beige"| [[Breast cancer]]
+| bgcolor="Beige" | [[Breast cancer]]
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Ophthalmologic'''
-|bgcolor="Beige"| Cantalamessa-baldini-ambrosi syndrome, Obal syndrome, Retinitis pigmentosa, deafness, mental retardation, hypogonadism.
+| bgcolor="Beige" | Cantalamessa-baldini-ambrosi syndrome, Obal syndrome, Retinitis pigmentosa, deafness, mental retardation, hypogonadism.
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Overdose/Toxicity'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Psychiatric'''
-|bgcolor="Beige"| [[Libido|sexual arousal]]
+| bgcolor="Beige" | [[Libido|sexual arousal]]
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Pulmonary'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Renal/Electrolyte'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Rheumatology/Immunology/Allergy'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Sexual'''
-|bgcolor="Beige"| [[Libido|sexual arousal]]
+| bgcolor="Beige" | [[Libido|sexual arousal]]
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Trauma'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Urologic'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
-|-bgcolor="LightSteelBlue"
+|- bgcolor="LightSteelBlue"
 | '''Miscellaneous'''
-|bgcolor="Beige"| No underlying causes
+| bgcolor="Beige" | No underlying causes
 |-
 |}
@@ Line 491: / Line 491: @@
 **Premature thelarche and thelarche
 **Trauma
-==Causes in  male adolescents==
+==Causes in  male Adolescents==
 *Breast enlargement in male adolescents is defined as gynecomastia:<ref name="pmid17881754">{{cite journal| author=Braunstein GD| title=Clinical practice. Gynecomastia. | journal=N Engl J Med | year= 2007 | volume= 357 | issue= 12 | pages= 1229-37 | pmid=17881754 | doi=10.1056/NEJMcp070677 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17881754  }} </ref>
-**Persistent pubertal gynecomastia<ref name="pmid17881754">{{cite journal| author=Braunstein GD| title=Clinical practice. Gynecomastia. | journal=N Engl J Med | year= 2007 | volume= 357 | issue= 12 | pages= 1229-37 | pmid=17881754 | doi=10.1056/NEJMcp070677 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17881754  }} </ref>
+**Persistent pubertal gynecomastia
 **Drugs such as spironolactone,cimetidine,ketoconozale,recombinant human growth hormone, estrogens, antiandrogens, gonadotropin-releasing hormone (GnRH) agonists, 5-alpha-reductase inhibitors and human chorionic gonadotropin (hCG)<ref name="pmid22862307">{{cite journal| author=Deepinder F, Braunstein GD| title=Drug-induced gynecomastia: an evidence-based review. | journal=Expert Opin Drug Saf | year= 2012 | volume= 11 | issue= 5 | pages= 779-95 | pmid=22862307 | doi=10.1517/14740338.2012.712109 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22862307  }} </ref>
 **Idiopathic
@@ Line 502: / Line 502: @@
 **Testicular tumors
 **Chronic renal insufficiency
-==causes in female adolescents==
+==Causes in Female Adolescents==
 *Fibrocystic change<ref name="pmid10693180">{{cite journal| author=Templeman C, Hertweck SP| title=Breast disorders in the pediatric and adolescent patient. | journal=Obstet Gynecol Clin North Am | year= 2000 | volume= 27 | issue= 1 | pages= 19-34 | pmid=10693180 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10693180  }} </ref>
 *Juvenille fibroadenoma<ref name="pmid29080125">{{cite journal| author=Sanders LM, Sharma P, El Madany M, King AB, Goodman KS, Sanders AE| title=Clinical breast concerns in low-risk pediatric patients: practice review with proposed recommendations. | journal=Pediatr Radiol | year= 2018 | volume= 48 | issue= 2 | pages= 186-195 | pmid=29080125 | doi=10.1007/s00247-017-4007-6 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29080125  }} </ref>