[Gynaecomastia and mammography (author's transl)]

The term gynaecomastia indicates an increase in the mass of the normally rudimentary male breast; morphologically there is hyperplasia and differentiation of the epithelial and mesenchymal breast components. Gynaecomastia is not a disease in itself, but a symptom of some underlying disease or the result of drugs. Of 2895 breast operations performed at the surgical clinic of the University of Göttingen, 2.97% were operations on men with gynaecomastia. Amongst 79222 mammograms in the Radiological Clinic of the University, there were 900 mammograms (1.14%) of 392 men with gynaecomastia. Most benign and malignant conditions in men are retromammary in localisation. For this reason clinical evaluation is frequently wrong. The use of mammography as an additional diagnostic method in men is therefore more important than it is in women. Systematic analysis of the mammograms performed on men has made possible a classification of gynaecomastia according to the radiological appearances: I Septal linear structures (8.5%), II Opacities of varying density and size (26.5%), III Circular, usually inhomogenous shadows (15.5%), IV Homogeneous, demarcated foci of varying size (35.5%), V Soft-tissue hyperplasia-pseudo-gynaecomastia (10%).