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Gynecomastia: A systematic review.

Anders Fagerlund1, Richard Lewin1, Guglielmo Rufolo1

  • 1a 1 Department of Plastic Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, at Sahlgrenska University Hospital , Sweden.

Journal of Plastic Surgery and Hand Surgery
|June 9, 2015
PubMed
Summary
This summary is machine-generated.

Gynecomastia treatment options, including surgery and medication, are reviewed. The evidence quality for current treatments and their impact on quality-of-life is very low, necessitating further research.

Keywords:
Breastplastic surgery

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Quality of Life Research

Background:

  • Gynecomastia affects nearly one-third of males, impacting quality of life.
  • Treatment options include pharmacological and surgical interventions.
  • A systematic review is needed to assess evidence quality for treatments and quality-of-life outcomes.

Purpose of the Study:

  • To systematically review and analyze the quality of evidence for gynecomastia treatment modalities.
  • To evaluate the impact of different treatments on patients' quality of life.

Main Methods:

  • Systematic literature search conducted in major databases (PubMed, Medline, Scopus, Cochrane Library, SveMed+).
  • PRISMA statement and PICOS approach used for study selection and data extraction.
  • Methodological quality assessed using MINORS and evidence quality rated by GRADE.

Main Results:

  • Seventeen studies met inclusion criteria; 14 on treatment, 3 on quality of life.
  • All included studies were non-randomized, exhibiting a high risk of bias.
  • The overall quality of evidence according to GRADE was rated as very low.

Conclusions:

  • Surgical methods offer good results with varying complication rates; excision with liposuction is consistent.
  • Pharmacological anti-estrogen treatment is a safe option for pubertal gynecomastia.
  • The very low quality of evidence highlights the need for high-quality research in gynecomastia management.