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Yang Ming-Tian
GYNECOMASTIA AND
THE
TUMORS
OF
THE BREAST
This
paper presents
the
ap-
proaches to the tumors of the breast
in
male patients.Usually, carcinoma
of
the
breast in males is not frequently seen,
and may only account for
aboul
l-1
.5o/o
of the tumor occurred
in
females.
Carcinoma
of the breast
in
males
should be distinguished from
being
breast enlargement, which is
called
gynecomastia. Gynecomastia may oc-
cur physiologically in normal
males
at
pubefty, and
may persist through ado-
lescence. This
type
of breast
enlarge-
ment usually subsides spontaneously,
but if it presents a sufficiently serious
psychological problem, simple mastec-
tomy with preservation
of
the nipples
is
justified
since
any reasonable hormonal
treatment is inetfective. Gynecomastia
should always raise
the
suspicion
ol
benign
or
malignant tumor
of
the
breast.
Being fibroadenomas
of
the breast may
occur at any age but are uncommon
in
man. Marked degrees of breast devel-
opment
in
adolescent males
or
the on-
set
of
gynecomastia
in
later
lile
may
also indicate the presence of an estro-
gen-secreting tumor
of the
adrenal
gland, choriogenic tumors, and more
rarely, interstitial cell and granulosa cell
tumors of the testes
may produce
gynecomastia. Gynecomastia may also
be
seen in
males
with cirrhosis
of
the
liver and in areas of severe malnutri-
tion,
presumably in both instances be-
cause of failure of inactivation of circu-
lating estrogens. This condition
regu-
larly
follows iatrogenic administration
of
estrogen compounds in
the
proslate
and even occasionally occur during tes-
tosterone therapy in
eunuchoidism.
Transient gynecomastia may be also
associated with the administration of
common therapeutic agents
having
basic sterold structure such as digitalis
and spironolactone.
22
