[Gynecomastia. A follow-up study]

Classification of gynaecomastia as physiological/idiopathic is traditionally carried out by exclusion on the basis of the case history and results of the clinical examination. Out of 138 consecutive patients with gynaecomastia referred by general practitioners to the Surgical Gastroenterological Department K in Odense Hospital during the period 1978-1981 for treatment, 98 patients (71%) were classified in this manner. Following a period of observation ranging from four months to ten years, average 7.5 years, diseases were demonstrated in five of the physiological/idiopathic cases which were perhaps the causes of gynaecomastia. Employment of an extensive paraclinical programme of investigation would probably have resulted in demonstration of the underlying disease in three cases but would scarcely have improved the prognosis despite the possibility for earlier institution of treatment. Routine employment of extensive paraclinical investigations of selected patients with gynaecomastia of this type cannot be recommended on account of the limited diagnostic and therapeutic results. Classification of gynaecomastia based on the case history and clinical examination appears to be sufficiently exact in patients referred by general practitioners for treatment to a surgical department.