GYNAECOMASTIA

Objectives: To determine the causative factors and management of Gynaecomastia. Study Design: Observational case series study. Place and Duration of Study: Surgical Unit-1 Bahawal Victoria Hospital Bahawalpur, from 1st January 200 till 31st December 2007. Patient and Methods: Thirty male patients having breast swelling were included in this study. Relevant history was obtained. Appropriate physical examination was performed. Necessary investigations were done and after making a diagnosis appropriate treatment was done. A total of 30 patients were studied in the study period of 18 months. Those male patients who were having breast lesion other than benign enlargement (e.g. Ca. Breast, Breast/Abscess) were not included in the study. Necessary investigations were done. Subcutaneous Mastectomy was performed. Results: The most common age group developing gynaecomastia was of 20-30 years (60%). Bilateral gynaecomastia was observed in 76.66% and unilateral gynaecomastia in 23.33%. Idiopathic gynaecomastia was observed in 73.33% cases. Medical treatment was given with tamoxifen 10mg twice a day for the period of three months in 6 case (20%) and this remained effective in 5 case (83.33%). Subcutaneous mastectomy was performed in 17 cases (56.66%). Post-operative complications were seen in 4 cases (23.52%), the most common complication being wound hematoma in 2 cases (11.76%). Most of the patients (88.9%) were fully satisfied with the results of subcutaneous mastectomy. Conclusion: Gynaecomastia is the most common benign lesion of the male breast. As far as physiological gynaecomastia is concerned, patients should be observed for at least 2 years from the onset of their condition. In most of the cases spontaneous resolution occurs. Surgical treatment should be planned in whom spontaneous resolution does not occur. Surgery remains the mainstay of therapy and is frequently indicated for psychological and cosmetic reasons.