EAA clinical practice guidelines-gynecomastia evaluation and management.

Area of Science:

• Endocrinology
• Urology
• Oncology

Background:

• Gynecomastia (GM) is a benign proliferation of male breast glandular tissue, with prevalence varying by age.
• Infantile and pubertal GM often resolve spontaneously, while adult GM may indicate underlying pathology in 45-50% of cases.

Purpose of the Study:

• To establish clinical practice guidelines for the evaluation and management of gynecomastia.
• To differentiate GM from other breast conditions, including male breast cancer.

Main Methods:

• A literature search for 'gynecomastia' was conducted.
• Evidence-based recommendations were developed using the GRADE system.

Main Results:

• Five statements and fifteen clinical recommendations were formulated.
• Key recommendations include thorough medical history, physical examination (including genitalia), and selective laboratory/imaging investigations.

Conclusions:

• GM assessment aims to detect underlying pathologies and reversible causes.
• Management strategies include watchful waiting, testosterone treatment for deficiency, and surgery for persistent cases.
• Non-aromatizable androgens, SERMs, and AIs are generally not recommended.