GYNECOMASTIA

Gynecomastia (enlargement of the male breast) is a common finding in p atients seen by both primary care physicians and specialists. The pati ent's main concerns are discomfort (if present), cosmetic alteration, and breast cancer. For the clinician, however, a major consideration i s the possibility that gynecomastia may be the initial presenting symp tom of an inapparent malignancy or may be a manifestation of a serious underlying illness. The challenge to the physician lies in separating such patients with gynecomastia due to medical conditions requiring s pecific treatment from the great majority of individuals with gynecoma stia in whom there is no serious underlying pathology (Table 1).