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- BarrosAlfredo Carlos Simões Dornellas deACMastology Department, Hospital Sírio-Libanês, São Paulo, Brazil. clinab@terra.com.br and Marcelo de Castro Moura Sampaio.
- Mastology Department, Hospital Sírio-Libanês, São Paulo, Brazil. clinab@terra.com.br
- Sao Paulo Med J. 2012 Jan 1; 130 (3): 187197187-97.
AbstractGynecomastia (GM) is characterized by enlargement of the male breast, caused by glandular proliferation and fat deposition. GM is common and occurs in adolescents, adults and in old age. The aim of this review is to discuss the pathophysiology, etiology, evaluation and therapy of GM. A hormonal imbalance between estrogens and androgens is the key hallmark of GM generation. The etiology of GM is attributable to physiological factors, endocrine tumors or dysfunctions, non-endocrine diseases, drug use or idiopathic causes. Clinical evaluation must address diagnostic confirmation, search for an etiological factor and classify GM into severity grades to guide the treatment. A proposal for tailored therapy is presented. Weight loss, reassurance, pharmacotherapy with tamoxifen and surgical correction are the therapeutic options. For long-standing GM, the best results are generally achieved through surgery, combining liposuction and mammary adenectomy.
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