Treatment

Treatment for gynecomastia varies. Eliminating the cause is often the only intervention needed for treatment.1,3 For cases in which the symptoms are not causing distress or pain, the patient should be reassessed every 6 months.3

Medication Therapy


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Medication therapy for gynecomastia works best if initiated <12 months after onset of symptoms.1 Gynecomastia that has been symptomatic for >12 months can result in permanent fibrous breast tissue.1 At this time, no pharmacologic treatments for gynecomastia are approved by the US Food and Drug Administration. Tamoxifen, anastrozole, and danazol have been used off-label to treat this condition.1

Radiation and Surgery

Radiation and surgical removal have also been used to treat gynecomastia.1 In this case, surgical removal was performed secondary to patient discomfort and psychological stress.

Conclusion

In retrospect, this patient’s outcome could have been different. The patient’s lack of awareness regarding breast health caused him to wait before seeking medical treatment for his condition. If the patient had reported to the clinic earlier, he may have avoided the need for surgical intervention. Laboratory testing to determine the underlying cause of the patient’s gynecomastia should have been performed, as well.

This case demonstrates the importance of increasing awareness of breast disease in men. Recognition by the clinician of the potential for breast disease in men, as well as patient education and instruction on performing routine self breast examinations may have prompted earlier reporting.

Catherine A. Carrico, DNP, APRN-NP, FNP, is an assistant professor at Creighton University College of Nursing and a family nurse practitioner at Children’s Hospital and Medical Center, in Omaha, Nebraska. Elise C.  Pilger, DNP, APRN, AGNP-C, is a nurse practitioner at Barnes Healthcare Management Group in Columbia, Missouri.

References

1. Ladizinski B, Lee K, Higgins H, Federman D. Gynecomastia: etologies, clinical presentations, diagnosis, and management. South Med J. 2014;107(1):44-49.

2. Johnson R, Kermott C, Murad M. Gynecomastia – evaluation and current treatment options. Ther Clin Risk Manag. 2011;7:145-148.

3. Dickson G. Gynecomastia. Am Fam Physician. 2012;85(7):716-722.

4. Chau A, Jafarian N, Rosa M. Male breast: clinical and imaging evaluation of benign and malignant entities with histologic correlation. Am J Med. 2016;129(8):776-791.