Gynecomasty: literature review and clinical aspects

Authors

DOI:

https://doi.org/10.33448/rsd-v10i4.13684

Keywords:

Gynecomastia; Etiology; Diagnosis; Breast.

Abstract

Introduction: Gynecomastia is the benign development of the male breast. It has a physiological or pathological origin, as a consequence of an imbalance between the amounts of estrogen and androgen. It can generate discomfort, mastalgia, tenderness and enlargement of the breasts. Objectives: To carry out a literature review on the etiology of gynecomastia, its presentation characteristics and diagnosis. Method: A bibliographic survey was conducted based on an active search for scientific articles in the PubMed, Scielo and LILACS databases, with a time frame from 2015 to 2020. The research was carried out using the descriptors (DeCS) gynecomastia, etiology, diagnosis and breast. In the 3 databases, 79 articles were found. Of these, 12 were selected, which include the etiology of gynecomastia, presentation and evolution, in addition to the diagnosis. Articles that addressed pseudogynecomastia, the relationship between gynecomastia and the prognosis of patients with tumors, other breast lesions and adverse effects of drugs that cause gynecomastia were excluded. Results: The most affected age group is between 50 and 69 years old, with an incidence of 72%. The pubertal phase is the most prevalent of the physiological periods. In the senile period, contributions to gynecomastia come from hypogonadism, decreased testosterone concentration, altered LH and maintained estradiol values. Medical history and physical examination, with palpation of the breasts, are essential to establish the diagnosis. Conclusion: Gynecomastia is a benign condition. It is necessary to differentiate correctly between physiological and pathological. Individualized follow-up, with surgical indication in some cases, is essential to promote well-being and personal acceptance.

References

Blau, M., Hazani, R., & Hekma, D. (2016). Anatomy of the gynecomastia tissue and its clinical significance. Plast Reconstr Surg Glob Open, 4(8), e854. Recuperado de https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010345/

Cachaço, E. E., Elias, S., & Nazário, A. C. P. (2015). Ginecomastia. Femina, 43(5), 197-202. Recuperado de http://files.bvs.br/upload/S/0100-7254/2015/v43n5/a5315.pdf

Casarin, S.T., Porto, A.R., Gabatz, R.I.B., Bonow, C.A., Ribeiro, J.P., Mota, M.S. (2020). Tipos de revisão de literatura: considerações das editoras do Journal of Nursing and Health. J. nurs. Health, 10(5), e20104031. Recuperado de https://periodicos.ufpel.edu.br/ojs2/index.php/enfermagem/article/view/19924

Costanzo, P. R., Suárez, S., Aszpis, S. M., Usher, S. J. G., Pragier, U. M., & Cavoia, V. M., et al. (2015). Ginecomastia: aspectos clínicos y etiológicos - estudio retrospectivo y multicêntrico. Revista Argentina de Endocrinología y Metabolismo, 52(1), 22-28. Recuperado de http://www.scielo.org.ar/scielo.php?script=sci_arttext&pid=S851-30342015000100004

García, C. P., Jiménez, A. B. A., Lozano, L. C., & Moraño, C. C. (2018). Importancia de la anamnesis exhaustiva ante una ginecomastia unilateral inexplicada en un niño. Arch Argent Pediatr, 116(5), 655-658. Recuperado de https://www.sap.org.ar/docs/publicaciones/archivosarg/2018/v116n5a15.pdf

Gottlieb, S., Pasqualini, T., Martínez, A., Bengolea, S. V., Azaretzky, M., & Ciaccio, M., et al. (2015). Características clínicas y etiología de la ginecomastia en pacientes en edad prepuberal. Revista Argentina de Endocrinología y Metabolismo, 52(2), 57-65. Recuperado de http://www.raem.org.ar/numeros/2015-vol52/numero-02/57-65-endo2-3-gottlieb.pdf

Huang, S. H., Rivera, J., Barrios, M. C., Silvestre, R., & Pérez, R. G. (2016). Ginecomastia de origen multifactorial en el adulto mayor. revisión fisiopatológica de un caso. Revista Venezolana de Endocrinología y Metabolismo, 14(1), 45-55. Recuperado de http://ve.scielo.org/scielo.php?script=sci_arttext&pid=S1690-31102016000100006

Kanakis, G. A., Nordkap, L., Bang, A. K., Calogero, A. E., Bartfai, G. A., & Corona, G., et al. (2019). EAA clinical practice guidelines- gynecomastia evaluation and management. Andrology, 7(6), 778-793. Recuperado de https://pubmed.ncbi.nlm.nih.gov/31099174/

Lemaine, V., Cayci, C., Simmons, P. S. & Petty, P. (2013). Gynecomastia in Adolescent Males. Guest Editors, 27(1), 56-61. Recuperado de https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3706045/

Nuttall, F. Q., Warrieri, R. S., & Gannon, M. C. (2015). Gynecomastia and drugs: a critical evaluation of the literature. Eur J Clin Pharmacol, 71, 569-578. Recuperado de https://link.springer.com/article/10.1007/s00228-015-1835-x

Oraniec, I. C., & Zgliczynski, W. (2008). Phenotype of patients with gynecomastia. Endokrynol Pol, 59(2), 131-139. Recuperado de https://pubmed.ncbi.nlm.nih.gov/18465688/

Pusl, T., & Stoemmer, P. (2017). Gynecomastia: look beyond the obvious. The American Journal of Medicine, 130(10), 439-440. Recuperado de https://www.amjmed.com/action/showPdf?pii=S0002-9343%2817%2930489-8

Riveral, N. F., Eisenstein, E., & Cardoso, C. B. M. A. (2008). Relação da ginecomastia puberal com o índice de massa corporal. Arq Bras Endocrinol Metab, 5(1), 23-28. Recuperado de https://www.scielo.br/pdf/abem/v53n4/v53n4a08.pdf

Soliman, A. T., Sanctis, V., & Yassin, M. (2017). Management of adolescent gynecomastia: an update. Acta bio-medica: Atenei Parmensis, 88(2), 204-213. Recuperado de https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166145/

Ukaonu, C. E., JR, G. M. C., & Curtis, S. A. (2017). Severe male breast enlargement. Am Fam Physician, 95(9), 583-584. Recuperado de https://pubmed.ncbi.nlm.nih.gov/28671390/

Wang, C., Yu, N., Zhu, L., & Zeng, A. (2019). Idiopathic prepubertal unilateral gynecomastia. Clinical Case Report, 98(40), e17374. Recuperado de https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6783188/

Published

30/03/2021

How to Cite

MATOS, L. L. P. .; SOUZA, A. L. R. de . Gynecomasty: literature review and clinical aspects. Research, Society and Development, [S. l.], v. 10, n. 4, p. e4310413684, 2021. DOI: 10.33448/rsd-v10i4.13684. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/13684. Acesso em: 11 apr. 2021.

Issue

Section

Health Sciences