Current concepts in gynaecomastia

Gynaecomastia is a common breast condition. Each case merits a careful and complete history, with thorough examination and investigations being required in selected patients with progressive disease or suspected sinister pathology. Treatment is usually indicated for any underlying cause, associated symptoms and the gynaecomastia itself. Treatment may be either medical or surgical but must be individualised. Medical treatment may be especially advocated in the symptomatic group. The indications for surgery include failure of medical treatment, intolerable side-effects of necessary drugs, malignancy, small lesions which cause significant distress and patients with large and ptotic gynaecomastia. A careful programme of counselling, pre-operatively in particular, may help to minimise litigation.