GYNECOMASTIA

Gynecomastia (enlargement of the male breast) is a common finding in patients seen by both primary care physicians and specialists. The patient's main concerns are discomfort (if present), cosmetic alteration, and breast cancer. For the clinician, however, a major consideration is the possibility that gynecomastia may be the initial presenting symptom of an inapparent malignancy or may be a manifestation of a serious underlying illness. The challenge to the physician lies in separating such patients with gynecomastia due to medical conditions requiring specific treatment from the great majority of individuals with gynecomastia in whom there is no serious underlying pathology (Table 1).