Gynaecomastia in 786 Adult Men - Clinical and Biochemical findings

Objective - Gynaecomastia is a benign proliferation of glandular tissue of the breast, however, it is an important clinical observation because it can be the first symptom of an underlying disease. Some controversy exists concerning the clinical importance of an in-depth investigation of men who develop gynaecomastia. We hypothesize that a thorough work-up is required in adult men with gynaecomastia. Design- All adult men (n=818) referred to a secondary level andrological department at Rigshospitalet in Copenhagen, Denmark in a four-year period (2008-2011) under the diagnosis of gynaecomastia (ICD-10: N62) were included. Methods - Thirty-two men did not have gynaecomastia when examined were excluded; leaving 786 men for final analyses. They went through an andrological examination, ultra sound of the testicles and analysis of endogenous serum hormones levels. Results - In 45% of men with adult onset of gynaecomastia (≥18 years) an underlying, and often treatable, cause could be detected. In men younger at onset an underlying cause for gynaecomastia could be detected in merely 7.7%. The study is limited by the fact that we did not have access to investigate men who were referred directly by their GP to private clinics of plastic surgery, or who sought cosmetic correction without consulting their GP first. Conclusions - Our study demonstrates the importance of a thorough examination, and provides a comprehensible examination strategy, to disclose underlying pathology leading to development of gynaecomastia in adulthood.