Expectant attitude is the most common attitude and recommended when a true gynecomastia objective, considering that in most cases is a physiological problem, transitional or secondary to a cause that can be treated or suspend (drugs) . We need reassurance about the benign nature of the problem and make revisions every 3-6 months to see the evolution.
Medicine:
- Tamoxifen: is a selective estrogen receptor modulator (SERM). It is the most studied drug and, for the moment, which shows better results. Presents good results in reducing breast size, improving associated symptoms such as pain, and even complete remission in a few years in 50-80% of cases. No recurrences were observed no major side effects. Is the first-line treatment.
- Raloxifene: is also a selective estrogen receptor modulator that blocks the effects of estrogen in the breast. Although good results seem to its effects are unknown long term.
- Danazol: is an androgen which decreases the production of FSH, LH and estrogen. Presents adverse effects such as weight gain.
- Anastrozole: is a selective aromatase inhibitor that decreases estrogen levels and increases testosterone levels.
Surgery is reserved for confirmed cases of breast cancer, or if it is a true gynecomastia, which persists despite medical treatment or is a major patient aesthetic or psychological problem. There are different techniques, the most used subcutaneous mastectomy, reduction mammoplasty, or liposuction. The results are usually pretty good from the aesthetic point of view.
Preventive treatment of gynecomastia in patients receiving adjuvant hormonal therapy for prostate cancer: due to the high incidence of gynecomastia in these patients (which can cause dropout) have been proposed preventive treatments to prevent the onset of gynecomastia . The two most commonly used alternatives are radiotherapy and tamoxifen.
No comments:
Post a Comment