{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T15:00:20Z","timestamp":1780930820480,"version":"3.54.1"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2003,4,15]],"date-time":"2003-04-15T00:00:00Z","timestamp":1050364800000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2003,4]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> \u2003The purpose of the present paper was to review the management of men referred to a breast clinic with presumed gynaecomastia.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> \u2003A retrospective analysis was carried out of 175 men over the age of 16\u2003years who presented with breast enlargement and\/or \u2018lumps\u2019, during a 7\u2010year period to a single\u2010surgeon. All patients had complete biochemical assessment (liver function tests, \u03b3\u2010glutamyl transferase, prolactin, \u03b1\u2010fetoprotein, \u03b2\u2010human chorionic gonadotropin), and mammography and\/or ultrasound with fine\u2010needle biopsy if indicated.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> \u2003One hundred and seventy\u2010five men, median age 44\u2003years (range: 18\u221289\u2003years), were assessed. Thirty\u2010nine had bilateral true gynaecomastia and 88 had unilateral gynaecomastia (53% left). Carcinoma of the breast was diagnosed in eight, pseudo\u2010\u00adgynaecomastia in 18, 13 had physiological pubertal changes only and nine had other diagnoses. Adverse drug reactions were possibly implicated in the aetiology of 47 patients, alcohol in seven patients, cannabis in one patient, testicular malignancy in four patients and hepatocellular carcinoma in one patient. Five patients were found to have hyperprolactinaemia. Twenty\u2010four per cent of patients were reassured without intervention; 18% failed to attend follow up. Sixteen per cent were treated with danazol, 15% underwent surgery and 28 were referred for management of their cause. Danazol was effective in 81%, and three patients required surgery when danazol was ineffective. One further patient developed testicular cancer 9\u2003months after presentation.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> \u2003Men presenting to a breast clinic require clinical assessment to exclude diagnoses other than gynaecomastia. True gynaecomastia can be managed with exclusion of causative factors by non\u2010invasive investigation and examination. Many patients can be reassured as to the idiopathic nature of the condition and many will fail to attend follow up. Danazol is successful in some patients and surgery should be reserved for resistant cases.<\/jats:p>","DOI":"10.1046\/j.1445-1433.2002.02584.x","type":"journal-article","created":{"date-parts":[[2004,12,19]],"date-time":"2004-12-19T00:15:56Z","timestamp":1103415356000},"page":"213-216","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["How should gynaecomastia be managed?"],"prefix":"10.1111","volume":"73","author":[{"given":"Ian R.","family":"Daniels","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham T.","family":"Layer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2003,4,15]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-197301000-00009"},{"key":"e_1_2_6_3_2","first-page":"105","article-title":"Gynaecomastia: Presentation, aetiology and management","volume":"4","author":"Williams TG","year":"1992","journal-title":"Curr. 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