Symptoms And Diagnosis of Gynecomastia

The main symptom of gynecomastia is the visible increase in mammary gland. Usually asymptomatic, but in case of rapid development of the injury, you may receive local pain.

Depending on the cause that produces it, gynecomastia is accompanied by a symptoms or others. Sometimes the secretion of milk through the nipple may occur, which may indicate hyperprolactinemia. The appearance of other symptoms such as nipple retraction or bloody discharge through it have to warn of the possible existence of breast cancer, so if these symptoms should see a doctor.

Diagnosis of gynecomastia

In most cases with clinical history, physical examination and a blood hormone, is sufficient to reach the diagnosis of gynecomastia and its cause. However, sometimes this is not enough and conducting more complex tests required.

Clinical history is important, wing when performing the anamnesis (clinical interview by the physician to the patient about their history and symptoms), collect some basic data about the patient, among which include their age, duration of gynecomastia, and what associated symptoms (enlarged or palpable mass, nipple discharge, this retraction, skin changes, pain, or other symptoms) are. In addition, it is mandatory to ask about the use of drugs or other substances that may have occurred growth of the mammary gland. Finally, one should ask the patient about personal history of testicular, liver or kidney disease, and family history of gynecomastia.

Physical examination is important to conduct a thorough and detailed as possible physical examination including, of course, the examination of the breasts. You should measure weight, height and body mass index patient to rule that gynecomastia is caused by obesity. The physical examination should include a bilateral breast examination (inspection and palpation of the breasts with the patient lying, covering it between two fingers and approximating to detect resistance or palpable mass), abdominal examination (to assess the presence of liver disease, gastric, renal or adrenal), testicular palpation thyroid (goiter or thyroid to rule masses) and (looking gonadal tumors). Finally, the physical examination should be used to confirm or rule out the presence of lymph nodes.

Blood tests in patients with a physiological asymptomatic or gynecomastia due to drugs, conducting a blood test is required. However, if it is persistent or cause gynecomastia not confirmed the clinical history and physical examination is recommended that a complete analysis as to show the blood levels of various hormones (hCG, LH, FSH, prolactin, testosterone and estradiol) and evaluate hepatic, renal and thyroid function. Basically the purpose of analytics is to find the cause of gynecomastia, thus ruling concerned a secondary gynecomastia. Analytical results should always be interpreted by a physician.

Imaging: recommended to differentiate true gynecomastia suspicious masses of cancer, when the history and physical examination suggest so. These tests should not be performed routinely and should not replace the physical examination, but to be indicated only when there is clinical suspicion of malignancy. The imaging tests most commonly used are the mammogram (that is useful for the detection of breast cancer test, although not as much as women), ultrasound and computed tomography, and the choice of one or the other depends on each case in particular.

Histological evidence (allow to extract tissue for analysis in the laboratory) must be indicated only when there is suspicion of breast cancer by physical examination and imaging tests. You can perform FNA (fine needle aspiration), biopsy or mastectomy.