Incidental Pathologic Findings in Young Men with Gynecomastia

Area of Science:

• Endocrinology
• Oncology
• Adolescent Medicine

Background:

• Pathologic examination of gynecomastia tissue in young males is debated due to low breast cancer incidence.
• This study evaluated the necessity of routine tissue analysis in adolescents with gynecomastia.

Purpose of the Study:

• To assess the prevalence and nature of histopathologic findings in adolescent males undergoing mastectomy for gynecomastia.
• To inform guidelines on routine tissue analysis for this demographic.

Main Methods:

• Retrospective review of 268 male patients (mean age 16.6 years) who underwent mastectomy for gynecomastia.
• Analysis of demographics, medical history, surgical details, and pathological results.

Main Results:

• 95.1% of patients had normal histopathology.
• Abnormal findings included nonproliferative changes, proliferative changes without atypia, atypical ductal hyperplasia (ADH), and ductal carcinoma in situ (DCIS).
• Three patients (1.2%) had ADH and/or DCIS; these patients were obese but lacked other risk factors. No invasive carcinoma was found.

Conclusions:

• Potentially increased breast cancer risk findings (ADH/DCIS) were identified in 1.2% of male adolescents.
• The incidence of these findings is comparable to that in similarly aged females undergoing breast reduction.
• Routine tissue analysis is advised due to the unknown natural history of these precursor lesions in young males.