Assessing adolescent gynecomastia: The role of shear wave ultrasound elastography

Pubertal gynecomastia (PG) is defined as benign proliferation of male breast tissue. Ultrasonography is frequently used for follow-up of symptomatic gynecomastia. Shear wave elastography (SWE) is an auxiliary tool for the diagnosis of breast disorders. Our aim is to evaluate SWE properties of breast tissue in PG.

Fifty consecutive adolescents, aged 10-18 with a diagnosis of gynecomastia were prospectively included in the study. Following clinical and laboratory evaluation, participants underwent B-mode ultrasound and classified as nodular, dendritic, and diffuse pattern. SWE and hormonal values of all groups were recorded. Then, statistical analysis was performed.

Briefly, 92 breasts (43 left and 49 right; 42 bilateral and 8 unilateral) were included in the analyses. There were no significant differences in clinical parameters including age, BMI-SDS, estradiol (E2), testosterone (T), and E₂/T levels within groups (p > 0.05). Breast volume and SWE levels were significantly different in all groups (p < 0.05). SWE values were significantly lower for those of dendritic pattern than in nodular pattern (p < 0.05). ROC analysis revealed that for the best the cut-off value of 13.7 kPa, area under the curve value was 0.922 with 84% sensitivity and 87% specificity.

SWE values were significantly lower in patients with dendritic gynecomastia than those with nodular gynecomastia. Knowledge of the SWE values for the initial diagnosis and follow-up values could help avoid unnecessary interventions.