Gynecomastia natural history, complications and prognosis

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

The signs and symptoms of gynecomastia typically develop in neonatal, pubertal age or in the elderly.^[1]^[2]^[3]
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:^[4]^[5]^[6]

Persistent pubertal gynecomastia
Breast cancer
Psychological stress like:
- depression
- Reduced self-esteem
- Body dissatisfaction

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

↑ Braunstein GD (1993). “Gynecomastia”. N Engl J Med. 328 (7): 490–5. doi:10.1056/NEJM199302183280708. PMID 8421478.
↑ 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.
↑ 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.
↑ 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).
↑ 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.
↑ 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.
↑ Wiesman, IM.; et al. “Gynecomastia: An Outcome Analysis“.
↑ 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.
↑ 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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[pmid8421478-1] Braunstein GD (1993). “Gynecomastia”. N Engl J Med. 328 (7): 490–5. doi:10.1056/NEJM199302183280708. PMID 8421478.

[pmid2137877-2] 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.

[pmid24872741-3] 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.

[pmidorg/10.1016/j.amjmed.2016.01.009-4] 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).

[pmid26408934-5] 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.

[pmid26151806-6] 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“.

[pmid21712702-8] 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.

[pmid28451801-9] 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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