1
|
Yang X, Zheng X, Zhang M, Huang J, Huang P, Wang J. Drug-Induced Gynecomastia: Data Mining and Analysis of the FDA Adverse Event Reporting System Database. Clin Epidemiol 2024; 16:617-630. [PMID: 39280118 PMCID: PMC11402344 DOI: 10.2147/clep.s470959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Accepted: 08/30/2024] [Indexed: 09/18/2024] Open
Abstract
Purpose Drug-induced gynecomastia significantly affects patient health and quality of life. This study aimed to perform an exploratory analysis of gynecomastia reports and the most commonly associated medications within the FAERS database. Patients and Methods A comprehensive analysis of the FAERS from January 2004 to December 2023 was conducted. Disproportionality analysis and subsequent sensitivity analysis were performed to identify drugs potentially associated with gynecomastia, utilizing the reported odds ratio (ROR). Logistic regression analysis was employed to assess potential risk factors. The Weibull shape parameter (WSP) test was used to assess the time-to-onset characteristics of the top drugs associated with gynecomastia. Results The study identified 30,265 cases of gynecomastia, primarily associated with nervous system drugs, accounting for 85.50% of cases. Notably, risperidone accounted for 80.81% of the total cases. Among the 165 agents with ≥ 5 cases of gynecomastia, the strongest signals were exhibited by risperidone (ROR 602.38, 95% CI 585.07-620.20), dutasteride (ROR 17.18, 95% CI 15.55-18.89), spironolactone (ROR 15.8, 95% CI 13.99-17.83), and paliperidone (ROR 7.16, 95% CI 6.55-7.84). In the sensitivity analysis of disproportionality, unexpected associations were observed, such as montelukast (n = 21, ROR 1.94, 95% CI 1.26-2.98). The logistic regression analysis indicated that the risk of risperidone-induced gynecomastia was significantly lower in adults compared to pediatric patients (OR 0.12, 95% CI 0.09-0.15) and in patients with higher body weight than in those with lower body weight (OR 5.24, 95% CI 3.62-7.76). The WSP test showed that gynecomastia induced by most of the top 10 common agents tends to occur in an early failure mode. Conclusion The rankings and signal strengths of drugs associated with gynecomastia were extracted from the FAERS. The age distribution and time-to-onset distribution of the top 10 drugs linked to gynecomastia were investigated, which can facilitate accurate clinical recognition of drug-induced gynecomastia.
Collapse
Affiliation(s)
- Xiuli Yang
- Center for Clinical Pharmacy, Cancer Center, Department of Pharmacy, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, People's Republic of China
| | - Xiaochun Zheng
- Center for Clinical Pharmacy, Cancer Center, Department of Pharmacy, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, People's Republic of China
| | - Miaomiao Zhang
- Center for Clinical Pharmacy, Cancer Center, Department of Pharmacy, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, People's Republic of China
- School of Pharmacy, Hangzhou Normal University, Hangzhou, Zhejiang, People's Republic of China
| | - Jinlong Huang
- Center for Clinical Pharmacy, Cancer Center, Department of Pharmacy, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, People's Republic of China
- School of Pharmacy, Hangzhou Normal University, Hangzhou, Zhejiang, People's Republic of China
| | - Ping Huang
- Center for Clinical Pharmacy, Cancer Center, Department of Pharmacy, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, People's Republic of China
| | - Jiangfeng Wang
- Center for Clinical Pharmacy, Cancer Center, Department of Pharmacy, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, People's Republic of China
- Department of Pharmaceutical Services, Ipharmacare Ltd, Hangzhou, Zhejiang, People's Republic of China
| |
Collapse
|
2
|
Uldbjerg CS, Lim YH, Bräuner EV, Juul A. Increased Morbidity in Males Diagnosed With Gynecomastia: A Nationwide Register-based Cohort Study. J Clin Endocrinol Metab 2023; 108:e380-e387. [PMID: 36718997 PMCID: PMC10271232 DOI: 10.1210/clinem/dgad048] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/15/2023] [Accepted: 01/24/2023] [Indexed: 02/01/2023]
Abstract
CONTEXT Evidence on the long-term and general health of males with gynecomastia is lacking. OBJECTIVES To assess health before and following a diagnosis of gynecomastia. METHODS A register-based cohort study of 140 574 males, of which 23 429 were diagnosed with incident gynecomastia and age- and calendar-matched (1:5) to 117 145 males without gynecomastia from the background population. Males with gynecomastia were stratified into males without (idiopathic) or with a known preexisting risk factor (disease/medication). Cox and logistic regression models investigated associations of disease risk according to International Classification of Diseases 10th revision sections following and before gynecomastia diagnosis. RESULTS A total of 16 253 (69.4%) males in the cohort were identified with idiopathic gynecomastia. These males had a statistically significant higher risk of future disease across all included disease chapters (hazard ratio [HR], 1.19-1.89), with endocrine diseases representing the greatest disease risk (HR, 1.89; 95% CI, 1.76-2.03). The highest subchapter disease risk was observed for disorders of the endocrine glands (odds ratio [OR], 7.27; 95% CI, 6.19-8.54). Similarly, the ORs of comorbidities were higher across all included disease sections (OR, 1.05-1.51), except for psychiatric disease (OR, 0.72; 95% CI, 0.68-0.78), with the highest association with musculoskeletal/connective tissue (OR, 1.51; 95% CI, 1.46-1.57) and circulatory (OR, 1.36; 95% CI, 1.29-1.43) diseases. CONCLUSIONS The presence of idiopathic gynecomastia is an important first clinical symptom of an underlying disease and a significant predictor of future disease risk. These findings should stimulate more awareness among health care providers to increase identification of gynecomastia and its causes in males.
Collapse
Affiliation(s)
- Cecilie S Uldbjerg
- Department of Growth and Reproduction, Copenhagen University Hospital—Rigshospitalet, University of Copenhagen, Copenhagen 2100, Denmark
- The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen 2100, Denmark
| | - Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen 1353, Denmark
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Elvira V Bräuner
- Department of Growth and Reproduction, Copenhagen University Hospital—Rigshospitalet, University of Copenhagen, Copenhagen 2100, Denmark
- The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen 2100, Denmark
| | - Anders Juul
- Department of Growth and Reproduction, Copenhagen University Hospital—Rigshospitalet, University of Copenhagen, Copenhagen 2100, Denmark
- The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen 2100, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen 2100, Denmark
| |
Collapse
|
3
|
Pediatric endoscopic subcutaneous mastectomy (pesma) with liposuction in adolescents with gynecomastia. Surg Endosc 2023; 37:766-773. [PMID: 36050608 PMCID: PMC9839820 DOI: 10.1007/s00464-022-09550-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 08/07/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Surgical techniques for treatment of gynecomastia are increasingly less invasive. We described technical standardization of pediatric endoscopic subcutaneous mastectomy (PESMA) with liposuction. METHODS All adolescents with primary gynecomastia, operated using PESMA with liposuction over the period June 2014-July 2021, were included. The video recording of procedures was analyzed to standardize the operative technique. After patient installation, 3 trocars were placed on the mid-axillary line. The technique included 5 steps: (1) subcutaneous injection of lipolysis solution and liposuction; (2) creation of working space using an inflated balloon; (3) gland dissection using 5-mm sealing device; (4) specimen extraction through the largest trocar orifice; and (5) placement of suction drainage tube. RESULTS Twenty-four male adolescents, operated for Simon's grade 2B and 3 gynecomastia using PESMA with liposuction over the study period, were included. Mean patient age was 16 years (range 15-18). Gynecomastia was bilateral in 19/24 (79.2%) and unilateral in 5/24 (20.8%). One (4.1%) conversion to open was reported. The mean operative time was 87 min (range 98-160) for unilateral and 160 min (range 140-250) for bilateral procedure. The mean length of stay was 2.2 days (range 1-4). Patients wore a thoracic belt for 15 up to 30 days postoperatively. Post-operative complications occurred in 5/24 (20.8%): 2- or 3 mm second-degree burns in 4 (16.7%) and subcutaneous seroma in 1 (4.1%). All complications were Clavien 2 grade and did not require further treatment. Aesthetic outcomes were very good in 21/24 (87.5%). Three (12.5%) boys had persistent minimal breast asymmetry but did never perceive it negatively. CONCLUSION PESMA combined with liposuction was feasible and safe for surgical treatment of gynecomastia in this selected cohort of patients. Although challenging, this procedure provided good aesthetic results, with no scars on the anterior thoracic wall. Standardization of the operative technique was a key point for successful outcome.
Collapse
|
4
|
Hong JY, Park SJ, Kim SY, Kim BJ. Efficacy and Safety of Cold-Induced Noninvasive Targeted Fat Reduction in Pseudogynecomastia. Ann Dermatol 2022; 34:412-418. [PMID: 36478423 PMCID: PMC9763905 DOI: 10.5021/ad.21.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 04/20/2022] [Accepted: 08/01/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Treatment options for pseudogynecomastia are limited, and the demand for noninvasive breast fat reduction is increasing. OBJECTIVE We evaluated the efficacy and safety of a cold-induced lipolysis device for treating pseudogynecomastia. METHODS In this 16-week prospective trial, a total of 15 male patients with pseudogynecomastia were treated twice with cryolipolysis. The primary endpoint was a change in the chest circumference from baseline at posttreatment week 8. Secondary endpoints were changes in body weight, fat thickness assessed using ultrasonography, independent evaluator- and patient-rated improvement, and Simon's gynecomastia class (SGC) grading. RESULTS The primary assessment, a reduction of 3.05 cm in the mean chest circumference at 8 weeks post-treatment compared to baseline, was statistically significant. The treatment effect was cumulative, with a steady decrease in chest circumference and fat thickness over the 16-week study period. The mean pain score immediately after the first session of treatment was 2.0±1.36, based on a scale of 0~10, with a score of 10 being the worst pain ever experienced. The pain decreased substantially after the end of the procedure. CONCLUSION Cryolipolysis was demonstrated to be an effective and safe option for reducing breast fat in pseudogynecomastia. Male with mild to moderate breast enlargement without skin excess can be ideal candidates.
Collapse
Affiliation(s)
- Ji Yeon Hong
- Department of Dermatology, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Su Jung Park
- Department of Dermatology, Chungnam National University Sejong Hospital, Sejong, Korea.,Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | | | - Beom Joon Kim
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| |
Collapse
|
5
|
Yao Q, Zhai H, Huang H, Lin J, He W. A comparative study of the efficacy of tamoxifen and Chinese patented medicine (Pingxiao capsules) in gynecomastia: A retrospective cohort study. Andrologia 2022; 54:e14640. [DOI: 10.1111/and.14640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 10/27/2022] [Accepted: 10/29/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Qianli Yao
- Department of Breast Surgery The First Affiliated Hospital of Jinan University Guangzhou China
| | - Hening Zhai
- Department of Digestive Endoscopy Center The First/Fifth Affiliated Hospital of Jinan University Guangzhou China
| | - Hailang Huang
- Department of General Surgery Guizhou Moutai Hospital Renhuai Guizhou China
| | - Junnan Lin
- Department of Cardiothoracic Surgery The First Affiliated Hospital of Jinan University Guangzhou China
- Department of Nursing Chaoshan Hospital, The First Affiliated Hospital of Jinan University Chaozhou China
| | - Weili He
- Department of Breast Surgery The First Affiliated Hospital of Jinan University Guangzhou China
| |
Collapse
|
6
|
Daniels J, Brickstock A, Charlton R. Gynaecomastia. BMJ 2022; 379:e069771. [PMID: 36265883 DOI: 10.1136/bmj-2021-069771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
7
|
Bharathidasan K, Curl J, Babu VK, Felton S, Nugent K. An Approach to Gynecomastia in Primary Care Clinics. South Med J 2022; 115:597-602. [PMID: 35922045 DOI: 10.14423/smj.0000000000001425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Gynecomastia is a more common finding in primary care clinics than is recognized. Because this finding can be easily overlooked, appropriate investigation and management often are missed. The workup of gynecomastia is highly individualized, based on the patient's presentation and related factors. It should be guided by thorough history taking and physical examination. Unless the patient has associated symptoms, or there is suspicion for an underlying clinical disorder causing the gynecomastia, the patient need not be investigated further. A breast ultrasound is not routinely recommended. Gynecomastia is a benign finding that will spontaneously regress in most patients; however, patients who are concerned with their physical appearance can be treated either medically or surgically. Patients who have had gynecomastia for more than 1 year tend to have fibrosis, which may be more difficult to treat. Management of gynecomastia is highly patient centered, following a detailed discussion about treatment goals and should be started early. Gynecomastia is not considered a premalignant condition; routine screening is not cost-effective, and imaging studies should be pursued only if physical examination findings suggest malignancy.
Collapse
Affiliation(s)
- Kavya Bharathidasan
- From the Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock
| | - Jordan Curl
- From the Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock
| | - Vedesh Kumar Babu
- From the Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock
| | - Shaili Felton
- From the Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock
| | - Kenneth Nugent
- From the Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock
| |
Collapse
|
8
|
Duquennoy-Martinot V, Calibre C, Guerreschi P, Belkhou A, Barry L. [Is it legitimate to propose surgery of the breast area before the end of puberty?]. ANN CHIR PLAST ESTH 2022; 67:425-437. [PMID: 35879119 DOI: 10.1016/j.anplas.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 11/01/2022]
Abstract
Breast surgery is usually recommended for women who have completed puberty. Indeed, during adolescence the breast is constantly changing, the patient's weight is often unstable, the risk of inflammatory scars (hypertrophic or keloid) is higher and disturbances of areolar sensitivity can affect the patient's quality of sexual life. In addition, the risk of infection is not negligible, especially during an acne outbreak. In case of early implant placement, iterative changes should be planned. Finally, the result obtained is not always stable but above all the lack of psychological maturity and the legal need to obtain the agreement of both parents are obstacles to early surgery. However, the authors argue for the possibility of surgical correction of the breast around puberty, in particular because of the very clear positive psychological impact. Other arguments are also detailed: to ensure a breast reconstruction in successive stages started early, to limit the repercussions of hypertrophy, to correct thoracic or skin anomalies. These indications are illustrated by numerous clinical cases demonstrating the need for customized surgery on a case-by-case basis.
Collapse
Affiliation(s)
- V Duquennoy-Martinot
- Service de chirurgie plastique et réparatrice, hôpital Salengro, 59037 Lille Cedex, France.
| | - C Calibre
- Service de chirurgie plastique et réparatrice, hôpital Salengro, 59037 Lille Cedex, France.
| | - P Guerreschi
- Service de chirurgie plastique et réparatrice, hôpital Salengro, 59037 Lille Cedex, France.
| | - A Belkhou
- Service de chirurgie plastique et réparatrice, hôpital Salengro, 59037 Lille Cedex, France.
| | - L Barry
- Service de chirurgie plastique et réparatrice, hôpital Salengro, 59037 Lille Cedex, France.
| |
Collapse
|
9
|
Berger O, Landau Z, Talisman R. Gynecomastia: A systematic review of pharmacological treatments. Front Pediatr 2022; 10:978311. [PMID: 36389365 PMCID: PMC9663914 DOI: 10.3389/fped.2022.978311] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 10/05/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Pubertal gynecomastia (PG), a benign condition with varied reported prevalence, typically appears at 13-14 years-old and is mostly idiopathic and self-limited. Psychologic impairments are common among adolescents with gynecomastia. Surgical intervention is reserved to severe cases and is offered towards the end of puberty. Pharmacological treatment is seldom given by clinicians mainly due to insufficient published data. We conducted this systematic literature review to assess the efficacy, safety, side effects, and complications of pharmacological treatments published. METHODS MEDLINE, Embase, and Cochrane CENTRAL were searched for the terms "gynecomastia", "pubertal", and "adolescent" in conjunction with medications from the Selective Estrogen Receptor Modulator (SERM), aromatase inhibitors (AI), and androgens groups in different combinations to optimize the search results. Exclusion criteria included: studies based on expert opinion, similar evidence-based medicine levels studies, and studies which discuss gynecomastia in adults. Selected articles were assessed by two authors. Data collected included: the level of evidence, population size, treatment regimen, follow-up, outcomes, complications, and side effects. RESULTS Of 1,425 published studies found and examined meticulously by the authors, only 24 publications met all the study research goals. These were divided into 16 publications of patients treated with SERM, of whom four had AI and four androgens. In general, the data regarding pharmacologic therapy for PG is partial, with insufficient evidence-based research. Tamoxifen and SERM drugs have long been used as treatments for PG. Tamoxifen was the chosen drug of treatment in most of the reviewed studies and found to be effective, safe, and with minimal side effects. CONCLUSIONS Pharmacological treatment as a new standard of care has an advantage in relieving behavioral and psychological distress. Although high quality publications are lacking, pharmacological intervention with tamoxifen is appropriate in select patients. Conduction large-scale high-quality studies are warranted with various drugs.
Collapse
Affiliation(s)
- Ori Berger
- Plastic Surgery Unit, Barzilai University Hospital Medical Center, Ashkelon, Israel
| | - Zohar Landau
- Division of Pediatrics, Barzilai University Medical Center, Ashkelon, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ran Talisman
- Plastic Surgery Unit, Barzilai University Hospital Medical Center, Ashkelon, Israel
| |
Collapse
|
10
|
Reddy RK, Dutt A, Charles WN, Hoyos A, Khajuria A. The 100 Most-Cited Articles in Liposuction: A Bibliometric Analysis. Ann Plast Surg 2021; 87:615-622. [PMID: 34711726 DOI: 10.1097/sap.0000000000003030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Liposuction is one of the most common cosmetic surgical procedures performed worldwide. Despite previous citation analyses in plastic surgery, the most-cited works in liposuction have not yet been qualitatively or quantitatively appraised. We hypothesized that use of validated outcome measures and levels of evidence would be low among these articles. Thus, we performed a bibliometric analysis aiming to comprehensively review the most-cited liposuction literature, evaluating characteristics and quality of the top 100 articles. METHODS The 100 most-cited articles in liposuction were identified on Web of Science, across all available journals and years (1950-2020). Study details, including the citation count, main subject, and outcome measures, were extracted from each article by 2 independent reviewers. The level of evidence of each study was also assessed. RESULTS The 100 most-cited articles in liposuction were cited by a total of 4809 articles. Citations per article ranged from 602 to 45 (mean, 92). Most articles were level of evidence 4 (n = 33) or 5 (n = 35), representative of the large number of case series, expert-opinion articles, and narrative reviews. Ten articles achieved level of evidence 3, 22 articles achieved level of evidence 2, and none reached level 1. The main subject was operative technique in 63 articles, followed by outcomes in 32 articles. Five articles assessed the metabolic effects of liposuction. Only 1 article used a validated objective cosmetic outcome measure, and none used validated patient-reported outcome measures. CONCLUSIONS This analysis provides an overview of the top cited liposuction literature. Overall, level of evidence was low, and no articles achieved the highest level of evidence. Improving the quality of literature requires prioritization of better-designed studies and incorporation of validated outcome measures, which will increase patient satisfaction and ensure provision of excellent, reproducible clinical care.
Collapse
Affiliation(s)
- Rohin K Reddy
- From the Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Atul Dutt
- From the Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Walton N Charles
- From the Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | | | | |
Collapse
|
11
|
Aesthetic Outcome of Gynecomastia Management with Conventional Liposuction and Cross-Chest Liposuction: A Prospective Comparative Study. Aesthetic Plast Surg 2021; 46:1063-1070. [PMID: 34636927 PMCID: PMC8507502 DOI: 10.1007/s00266-021-02611-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/19/2021] [Indexed: 11/29/2022]
Abstract
Background Liposuction is the most accepted technique for treatment of gynecomastia at present with or without residual gland tissue excision. Conventional liposuction uses incisions for introduction of cannula, made usually at the inframammary crease or axilla resulting in consequent scars. Cross-chest liposuction technique was introduced to avoid these additional scars and improve the aesthetic outcome. This study aimed to evaluate the difference between aesthetic outcome of conventional liposuction and cross-chest liposuction in treatment of gynecomastia. Method A prospective comparative study between 2 groups with 15 patients in each was conducted, one with conventional and the other cross-chest liposuction. Excision of residual gland tissue was performed through circum-areolar incision in both the groups. Aesthetic outcome was evaluated in both the groups using Likert scale and compared. Result The mean age of the patients was 22.6 years and the mean duration of presentation was 8.13 years. Satisfaction rate with conventional and cross-chest liposuction was 80% and 86%, respectively, as assessed by the patients. The rate was 80% and 77%, respectively, in both the groups as assessed by independent observer. The complication rate was 13.3% in conventional and 20% in cross-chest group. The difference in outcome was not statistically significant between two groups. Difference between the mean Likert scores of pre-operative and post-operative satisfaction was statistically significant for both the techniques. Conclusion The conventional and the cross-chest liposuction, both yield comparable results when used for treatment of gynecomastia in terms of aesthetic outcome. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266
Collapse
|
12
|
Arslan SC, Esin IS, Cayır A, Orbak Z, Dursun OB. The Relationship between Psychopathology, Self-esteem, Body Perception and Serum Sex Steroids in Pubertal Gynecomastia. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2021; 19:498-506. [PMID: 34294618 PMCID: PMC8316656 DOI: 10.9758/cpn.2021.19.3.498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 10/27/2020] [Accepted: 12/15/2020] [Indexed: 12/01/2022]
Abstract
Objective The current study aimed to investigate the psychopathology behind gynecomastia and potential associated problems regarding self-esteem and body perception, and the relationships of these variables with sex steroid levels in adolescents with pubertal gynecomastia. Methods The study included 50 normal weight male adolescents aged between 11 and 18 years with gynecomastia but without any chronic organic pathology, and 50 healthy pubertal male adolescents matched for age. The adolescents underwent psychopathology assessment by Development and Well-Being Assessment interviews; self-esteem was assessed using the Rosenberg Self-Esteem Scale; body perception was evaluated using the Body Image Perception Scale, and the relationship between these variables and sex steroid levels were explored. Results The results of the study revealed that the gynecomastia group had significantly greater internalization disorder (χ2 = 12.96, p < 0.001), and impairments in self-esteem (z = −1.975, p = 0.024) and body perception (z = −2.286, p = 0.022), and these variables were correlated with the gynecomastia stage. In the study group, cortisol levels were significantly higher (z = −2.330, p = 0.02) in adolescents with internalization disorder compared to those without, and cortisol levels increased in parallel with increased gynecomastia duration (r = 0.386, p = 0.006). Conclusion In our study, we found that gynecomastia, depending on its stage, may lead to internalization disorder and impair self-esteem and body perception. It was found that there was no direct relationship between these parameters and sex steroids in pubertal gynecomastia, except for high cortisol levels in adolescents with internalization disorder.
Collapse
Affiliation(s)
- Semiha Comertoglu Arslan
- Department of Child and Adolescent Psychiatry, Kahramanmaras Sutcu Imam University Medical Faculty, Kahramanmaras, Turkey
| | - Ibrahim Selcuk Esin
- Department of Child and Adolescent Psychiatry, Ataturk University Medical Faculty, Erzurum, Turkey
| | - Atilla Cayır
- Department of Child Endocrinology,Training and Research Hospital, Erzurum, Turkey
| | - Zerrin Orbak
- Department of Child Endocrinology, Ataturk University Medical Faculty, Erzurum, Turkey
| | - Onur Burak Dursun
- Department of Child and Adolescent Psychiatry, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey
| |
Collapse
|
13
|
Nnamani Silva ON, Ammanuel SG, Segobiano BM, Edwards CS, Hoffman WY. Assessing the Readability of Online Patient Education Resources Related to Gynecomastia. Ann Plast Surg 2021; 87:123-125. [PMID: 33346559 DOI: 10.1097/sap.0000000000002620] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The Internet has a plethora of online patient education resources for many symptoms and diseases. National medical governing bodies recommend that patient education materials are written at or below the eighth-grade level, and the literature suggests that health literacy has been linked to increased adherence to treatment regimens and improved outcomes. The primary aim of the study is to assess the readability of online patient materials relating to gynecomastia and ascertain the availability of patient materials in non-English languages. METHODS The readability of patient education materials relating to gynecomastia for academic-based websites and nonacademic websites was assessed using the Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), and Simple Measure of Gobbledygook (SMOG). The prevalence of non-English patient education materials was assessed for both academic-based and nonacademic websites. RESULTS Fifty-eight documents were collected across academic websites. Overall median values were 10.7 for the FKGL, 47.0 for the FRE, and 11.4 for the SMOG. For the 10 nonacademic institutions, the overall median values were 10.6 for the FKGL, 45.2 for the FRE, and 10.8 for the SMOG. No appreciable differences were observed for readability when stratified by region or source. The prevalence of non-English patient materials was 19.1% across institutions. None of the noninstitutional materials had information in non-English languages. CONCLUSIONS The readability of patient education materials related to gynecomastia is at higher levels than recommended by national organizations. There are limited non-English patient education materials. Future efforts should focus on improving the readability and accessibility of patient materials.
Collapse
Affiliation(s)
| | - Simon G Ammanuel
- From the University of California, San Francisco School of Medicine, San Francisco, CA
| | - Brett M Segobiano
- College of Arts and Letters, University of Notre Dame, South Bend, IN
| | - Caleb S Edwards
- From the University of California, San Francisco School of Medicine, San Francisco, CA
| | - William Y Hoffman
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California, San Francisco, San Francisco, CA
| |
Collapse
|
14
|
Pfeiler PP, Luketina R, Dastagir K, Vogt PM, Mett TR, Kaltenborn A, Könneker S. Expected Reduction of The Nipple-Areolar Complex Over Time After Treatment of Gynecomastia with Ultrasound-Assisted Liposuction Mastectomy Compared to Subcutaneous Mastectomy Alone. Aesthetic Plast Surg 2021; 45:431-437. [PMID: 33108501 DOI: 10.1007/s00266-020-02029-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 10/18/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND The enlarged nipple-areola-complex (NAC) is a characterizing aspect of gynecomastia. OBJECTIVE The purpose of this study was to multidimensionally quantify the reduction of the NAC after a subcutaneous mastectomy (SCM) with or without ultrasound-assisted liposuction (UAL). MATERIALS AND METHODS A retrospective assessment of patients who underwent SCM +/- UAL due to gynecomastia over a period of 11 years was conducted. The NAC diameters were measured before and after surgery. In addition, a survey (including the BREAST-Q) regarding patient-oriented outcome was performed. RESULTS The study cohort consisted of 55 men and resulting 105 NACs (SCM n=63, SCM+UAL n=42). It could be shown that the reduction of the NAC considering all parameters (horizontal and vertical diameter and the area) was significantly larger (p=<0.001) in the SCM+UAL compared to the SCM only cohort. The mean reduction of the area in the SCM cohort was 1.60cm2 (SD 1.48) or 23.37% (SD 9.78) after 5.82 years and in the SCM+UAL cohort 2.60cm2 (SD 1.60) or 35.85% (SD 6,86) after 7.43 years. As independent significant factors for reduction of the NAC, the resection weight and SCM+UAL combination were identified. There were no significant differences regarding the patients' satisfaction measured with the BODY-Q (p=0.222) and the ordinal scale (p=0.445) between the two cohorts. CONCLUSIONS The SCM with UAL showed a larger reduction over time of the NAC compared to the SCM independent from the stage of gynecomastia. When planning the surgical treatment of gynecomastia, a technique and resection weight dependent reduction of the NAC over time must be considered. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Collapse
Affiliation(s)
- Peter P Pfeiler
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany.
- Department of Plastic, Reconstructive and Aesthetic Surgery, ISAR Klinikum, Munich, Germany.
| | - Rosalia Luketina
- Department of Hand, Plastic, Reconstructive and Burn Surgery, BG Trauma Center Eberhard Karl University Tübingen, Tübingen, Germany
| | - Khaled Dastagir
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany
| | - Peter M Vogt
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany
| | - Tobias R Mett
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany
| | - Alexander Kaltenborn
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany
| | - Sören Könneker
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany
| |
Collapse
|
15
|
Al Jabr FA, Zakaria OM, Al Mulhim MA, Alsuwailim AM, AlBurshaid H. Gynecomastia: a study to assess how students perceive this disease. GMS INTERDISCIPLINARY PLASTIC AND RECONSTRUCTIVE SURGERY DGPW 2021; 10:Doc01. [PMID: 33643766 PMCID: PMC7894277 DOI: 10.3205/iprs000151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background: Gynecomastia is a benign proliferation of the glandular male breast tissue. Gynecomastia etiology might be physiological or non-physiological such as medications, chronic diseases (e.g. hypogonadism), or steroid supplements. Aim: The purpose of this study was to assess the knowledge and understanding of gynecomastia among medical students and which resources were used to gain their understanding regarding the disease. Methods: Data for this qualitative, questionnaire-based cross-sectional study was collected on the basis of our own study objectives and from available questionnaires with similar objectives. The questionnaire was composed of 26 questions divided into many items that were recorded including sociodemographic data, gynecomastia symptoms, and holistic perception of the problem by the students. Exclusion criteria included those who refused to participate in the study and did not complete the questionnaire. Statistical tests were taken significant at p-value ≤0.05. All analyses were performed using SPSS, version 21. Results: A total of 200 medical students participated in this study, among them more males than females (64% vs. 36%). We observed that medical students had significantly more moderate knowledge with teachers as their source of information on gynecomastia (p=0.028) while with books (p=0.005) and internet (p=0.041) as their sources of information they had significantly more a higher level of knowledge. Conclusions: Medical students have overall insufficient knowledge about gynecomastia especially in physical examination and treatment aspects. Therefore, gynecomastia is to be considered more thoroughly in the curriculum.
Collapse
Affiliation(s)
- Faisal Ali Al Jabr
- Department of Surgery, College of Medicine, King Faisal University, Al-Ahsa, Eastern Province, Saudi Arabia
| | - Ossama Mohamed Zakaria
- Department of Surgery, College of Medicine, King Faisal University, Al-Ahsa, Eastern Province, Saudi Arabia
| | - Mohammed Ahmed Al Mulhim
- Department of Surgery, College of Medicine, King Faisal University, Al-Ahsa, Eastern Province, Saudi Arabia
| | | | | |
Collapse
|
16
|
Kanakis GA, Nordkap L, Bang AK, Calogero AE, Bártfai G, Corona G, Forti G, Toppari J, Goulis DG, Jørgensen N. EAA clinical practice guidelines—gynecomastia evaluation and management. Andrology 2019; 7:778-793. [DOI: 10.1111/andr.12636] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 04/01/2019] [Indexed: 12/20/2022]
Affiliation(s)
- G. A. Kanakis
- First Department of Obstetrics and Gynecology, Unit of Reproductive Endocrinology Aristotle University of Thessaloniki Thessaloniki Greece
| | - L. Nordkap
- University Department of Growth and Reproduction, and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC) Rigshospitalet Copenhagen Denmark
| | - A. K. Bang
- University Department of Growth and Reproduction, and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC) Rigshospitalet Copenhagen Denmark
| | - A. E. Calogero
- Department of Clinical and Experimental Medicine University of Catania Catania Italy
| | - G. Bártfai
- Department of Obstetrics, Gynecology, and Andrology Albert Szent‐Györgyi Medical University Szeged Hungary
| | - G. Corona
- Medical Department, Endocrinology Unit Azienda Usl, Maggiore‐Bellaria Hospital Bologna Italy
| | - G. Forti
- Department of Experimental Clinical and Biomedical Sciences ‘Mario Serio’, Endocrine Unit University of Florence Florence Italy
| | - J. Toppari
- Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology Turku University Hospital Turku Finland
| | - D. G. Goulis
- First Department of Obstetrics and Gynecology, Unit of Reproductive Endocrinology Aristotle University of Thessaloniki Thessaloniki Greece
| | - N. Jørgensen
- University Department of Growth and Reproduction, and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC) Rigshospitalet Copenhagen Denmark
| |
Collapse
|
17
|
Development of the BODY-Q Chest Module Evaluating Outcomes following Chest Contouring Surgery. Plast Reconstr Surg 2019; 142:1600-1608. [PMID: 30204682 DOI: 10.1097/prs.0000000000004978] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Plastic surgery to improve chest appearance is becoming increasingly popular. The BODY-Q is a patient-reported outcome instrument designed for weight loss and/or body contouring. In this article, the authors describe the development of a new module for masculinizing chest contouring surgery. METHODS Qualitative methods were used to develop the BODY-Q Chest Module, which was subsequently field-tested in Canada, the United States, The Netherlands, and Denmark between June of 2016 and June of 2017. Participants were aged 16 years or older and seen for gynecomastia, weight loss, or transman chest surgery. Data were collected using either a Web-based application or paper questionnaire. Rasch measurement theory analysis was performed. RESULTS The sample included 739 participants (i.e., 174 gynecomastia, 224 weight loss, and 341 gender-affirming). Rasch measurement theory analysis refined a 10-item chest scale and a five-item nipple scale. All items had ordered thresholds and good item fit, and scales evidenced reliability [i.e., person separation index and Cronbach alpha values were 0.95 and 0.98 (chest scale) and 0.87 and 0.94 (nipple scale), respectively]. Scores for both scales correlated more strongly with similar (satisfaction with the body) versus dissimilar (psychological and social function) BODY-Q scales. The mean scores for the chest and nipple scales were significantly higher (p < 0.001 on independent samples t tests) in participants who were postoperative compared with preoperative. CONCLUSION This new BODY-Q Chest Module is a clinically meaningful and scientifically sound patient-reported outcome instrument that can be used to measure outcomes for masculinizing chest contouring surgery.
Collapse
|
18
|
Gorvetzian J, Funderburk C, Copeland-Halperin LR, Nigriny J. Correction of the tuberous breast deformity in a prepubescent male patient: A surgical approach to an unusual problem. JPRAS Open 2019; 19:98-105. [PMID: 32158861 PMCID: PMC7061682 DOI: 10.1016/j.jpra.2018.12.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 12/15/2018] [Indexed: 11/08/2022] Open
Abstract
Purpose The management of the tuberous breast deformity in the female patient is well described. However, the presence of this variant in male patients is particularly rare, and few reports on the management of this condition are available. Case presentation A 12-year-old prepubescent male with bilateral gynecomastia and tuberous breast deformities was referred to our department for treatment. Our surgical management, including free nipple areolar complex harvest, mastectomy, removal of excess skin and subsequent nipple grafting, is presented in detail. We observed a cosmetically acceptable result with restoration of a masculine-appearing nipple-areolar complex and good patient satisfaction at 6-month follow-up. Conclusions Tuberous breast deformities in male patients are rare. Our treatment of a prepubertal male patient with this deformity using mastectomies and free nipple areolar complex grafting provided a cosmetically acceptable result. Here, we review the current literature on tuberous breast deformities in males and describe our approach to treatment.
Collapse
Affiliation(s)
- Joseph Gorvetzian
- University of New Mexico School of Medicine, 2425 Camino de Salud, Albuquerque, NM 87106, United States
| | - Christopher Funderburk
- Section of Plastic Surgery, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03755, United States
| | - Libby R Copeland-Halperin
- Section of Plastic Surgery, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03755, United States
| | - John Nigriny
- Section of Plastic Surgery, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03755, United States
| |
Collapse
|
19
|
Nuzzi LC, Firriolo JM, Pike CM, Cerrato FE, DiVasta AD, Labow BI. The Effect of Surgical Treatment for Gynecomastia on Quality of Life in Adolescents. J Adolesc Health 2018; 63:759-765. [PMID: 30279103 DOI: 10.1016/j.jadohealth.2018.06.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/25/2018] [Accepted: 06/26/2018] [Indexed: 01/22/2023]
Abstract
PURPOSE Despite the psychosocial deficits associated with gynecomastia, surgical treatment of adolescent gynecomastia remains controversial. This longitudinal cohort study measures changes in health-related quality of life following surgical treatment of gynecomastia in adolescents. METHODS The following surveys were administered to adolescents with gynecomastia and male controls, aged 12-21 years: Short-Form 36v2 (SF-36), Rosenberg Self-Esteem Scale (RSES), and Eating-Attitudes Test-26. Subjects completed surveys at baseline and postoperatively/at follow-up at 6 months, 1 year, 3 years, and 5 years. RESULTS From 2008 to 2017, 44 patients undergoing surgical treatment of gynecomastia and 64 unaffected male controls participated in our study. At baseline, gynecomastia patients scored significantly worse than controls on the RSES and in five SF-36 domains: general health, vitality, social functioning, role-emotional, and mental health. Scores significantly improved postoperatively on the RSES, and in four SF-36 domains: physical functioning, role-physical, bodily pain, and social functioning. Postoperatively, gynecomastia subjects scored similarly to controls in all SF-36 domains and the RSES. Young and overweight/obese patients and those with severe gynecomastia had the greatest postoperative improvement across survey measures. CONCLUSIONS Surgical treatment of gynecomastia significantly improves the quality of life of adolescents, with measurable improvements in physical and psychosocial functioning. Postoperatively, gynecomastia patients performed comparably to unaffected controls. Surgical treatment of gynecomastia in adolescents and young men has the potential to significantly improve quality of life, particularly in younger and overweight/obese patients and those with moderate to severe gynecomastia. Concerns regarding patient age and body mass index alone should not contraindicate surgery.
Collapse
Affiliation(s)
- Laura C Nuzzi
- Adolescent Breast Clinic, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Plastic and Oral Surgery, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Joseph M Firriolo
- Adolescent Breast Clinic, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Plastic and Oral Surgery, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Carolyn M Pike
- Adolescent Breast Clinic, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Plastic and Oral Surgery, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Felecia E Cerrato
- Adolescent Breast Clinic, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Plastic and Oral Surgery, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Amy D DiVasta
- Adolescent Breast Clinic, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts; Division of Adolescent/Young Adult Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Brian I Labow
- Adolescent Breast Clinic, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Plastic and Oral Surgery, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.
| |
Collapse
|
20
|
Abstract
Gynecomastia is defined as a unilateral or bilateral persistent benign mammary gland enlargement in men. Prevalence of asymptomatic gynecomastia is up to 65%. True gynecomastia must be distinguished from pseudogynecomastia. Typically, in true gynecomastia, a solid tissue mass is palpable below the nipple-areolar complex. Malignant changes such as male mammary carcinoma must always be ruled out. The causes of gynecomastia are diverse. An imbalance of female to male hormones triggers the onset of the disease. This imbalance can be caused by endogenous diseases like hyperthyroidism, chronic liver disease, primary or secondary gonadal failure, androgen resistance syndromes, medication, and drug abuse. A series of heart or hypertension medications can also trigger gynecomastia. A basic requirement of proper therapy planning is knowledge of the triggers and possible drug therapy options. Inquiring about the patient's lifestyle and medication history is essential. Drug therapy with tamoxifen may be considered at an early stage. For gynecomastia persisting over 12 months, surgical excision is the treatment of choice, and there are several surgical options available depending on the grade of the gynecomastia. A thoughtful approach to managing this condition can lead to high patient satisfaction.
Collapse
Affiliation(s)
- Kristin Baumann
- Clinic for Gynecology and Obstetrics, University Medical Centre Schleswig-Holstein Campus Lübeck, Lübeck, Germany
| |
Collapse
|
21
|
Calcaterra V, Clerici E, Ceolin V, Regalbuto C, Larizza D. Gynecomastia after euthyroidism restoration in a patient with type 1 diabetes and Graves' disease. Clin Case Rep 2018; 6:1481-1484. [PMID: 30147887 PMCID: PMC6099052 DOI: 10.1002/ccr3.1565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 03/30/2018] [Accepted: 04/14/2018] [Indexed: 11/06/2022] Open
Abstract
In patients with autoimmune disease, gynecomastia should not be considered as 1 of the first signs of hyperthyroidism, rather it is a breast pathology that can be present even when euthyroidism restoration is achieved. It is unknown whether the autoimmune nature of thyroid disorders or simply the hyperthyroidism effects breast changes.
Collapse
Affiliation(s)
- Valeria Calcaterra
- Pediatric Endocrinology UnitDepartment of Maternal and Children's HealthFondazione IRCCS Policlinico S. Matteo and University of PaviaPaviaItaly
| | - Edoardo Clerici
- Pediatric Endocrinology UnitDepartment of Maternal and Children's HealthFondazione IRCCS Policlinico S. Matteo and University of PaviaPaviaItaly
| | - Valeria Ceolin
- Pediatric Endocrinology UnitDepartment of Maternal and Children's HealthFondazione IRCCS Policlinico S. Matteo and University of PaviaPaviaItaly
| | - Corrado Regalbuto
- Pediatric Endocrinology UnitDepartment of Maternal and Children's HealthFondazione IRCCS Policlinico S. Matteo and University of PaviaPaviaItaly
| | - Daniela Larizza
- Pediatric Endocrinology UnitDepartment of Maternal and Children's HealthFondazione IRCCS Policlinico S. Matteo and University of PaviaPaviaItaly
| |
Collapse
|
22
|
Abstract
PURPOSE OF REVIEW Our aim is to review the steps of diagnosis and management of gynecomastia with a special focus on treatment of gynecomastia associated with androgen deprivation therapy for prostate cancer. RECENT FINDINGS Recent studies investigating tamoxifen and radiation therapy for both therapy and prophylaxis of bicalutamide-induced gynecomastia are reviewed. Gynecomastia is a common clinical problem, affecting between one and two thirds of middle-aged men. Diagnosis is typically made by history and physical exam. Common causes include chronic medical conditions and medications; however, unexplained gynecomastia should prompt laboratory work-up, followed by appropriate imaging studies to evaluate for hormone producing cancers. For patients taking bicalutamide for treatment of prostate cancer, tamoxifen or radiation therapy for gynecomastia are excellent options.
Collapse
|
23
|
Lee YK, Lee JH, Kang SY. Gynecomastia: glandular-liposculpture through a single transaxillary one hole incision. J Plast Surg Hand Surg 2017; 52:117-125. [DOI: 10.1080/2000656x.2017.1360318] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Yung Ki Lee
- Department of Plastic Surgery, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Jun Hee Lee
- Department of Plastic Surgery, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Sang Yoon Kang
- Department of Plastic Surgery, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| |
Collapse
|
24
|
Fricke A, Lehner GM, Stark GB, Penna V. Long-Term Follow-up of Recurrence and Patient Satisfaction After Surgical Treatment of Gynecomastia. Aesthetic Plast Surg 2017; 41:491-498. [PMID: 28280898 DOI: 10.1007/s00266-017-0827-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 02/10/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND "Gynecomastia" is an enlargement of the male breast. Our study aims to assess patient satisfaction as well as evaluate differences in recurrence rates in lipomatous and glandular gynecomastia 10-19 years postoperatively. METHODS Forty-one gynecomastia patients undergoing surgical treatment from 1997 to 2005 were invited for a follow-up examination 10-19 years postoperatively. Of these, 16 patients presented for a clinical examination. Patient satisfaction was measured with a validated questionnaire [consultation satisfaction questionnaire (CSQ)-9]. Furthermore, photo-material and patient charts were evaluated concerning preoperative macroscopical type of gynecomastia, BMI, and operative technique. RESULTS Mean follow-up time was 13.8 years (range: 10.5-19 years). Eight patients (50%) had presented with lipomatous and eight patients (50%) with glandular gynecomastia prior to surgery. One of the patients with glandular gynecomastia (12.5%) presented with recurrence at the time of follow-up, while five of the eight patients showing lipomatous gynecomastia (62.5%) presented with recurrence. Interestingly, younger patient groups tend to be more satisfied with the operative treatment of gynecomastia than older patient groups, especially regarding the improvement of self-esteem. CONCLUSIONS Long-term follow-up results showed that recurrence rates are significantly higher in patients with lipomatous gynecomastia than in patients with glandular gynecomastia, with BMI increase in patients with glandular and lipomatous gynecomastia showing no statistically significant differences. Furthermore, general patient satisfaction and improvement of self-esteem was higher in younger patient groups than older patient groups. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 . CLINICAL TRIAL REGISTRATION NUMBER DRKS00009630.
Collapse
|
25
|
Thompson JK, Ordaz DL. Chasing the Ideal: The Role of Body Image in Anabolic Steroid Misuse. J Adolesc Health 2016; 58:379. [PMID: 27013269 DOI: 10.1016/j.jadohealth.2016.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 01/29/2016] [Indexed: 11/19/2022]
Affiliation(s)
- J Kevin Thompson
- Department of Psychology, University of South Florida, Tampa, Florida
| | - D Luis Ordaz
- Department of Psychology, University of South Florida, Tampa, Florida
| |
Collapse
|