Gynaecomastia

  • Gynaecomastia in young men may be pubertal (physiological), or drug related these patients do not need referral and need reassurance
  • Gynaecomastia in older men – review medication as this is commonly a side effect of their treatment for another condition

Investigations

Investigations in patients presenting with symptoms and/or signs suggestive of breast cancer, investigation prior to referral is not recommended

For those with soft swelling which is unlikely to be due to malignancy consider:

  • Bloods
    (fbc/lft/u&e/oestradial/fsh/lh/testosterone/sex hormone binding globulin/alpha feto protein/beta hcg and prolactin)

Management

  • Gynaecomastia in young men may be:
    • pubertal (physiological)
    • drug related e.g. spironolactone, digoxin, phenothiazines, epilim, PPIs, cimetidine, finasteride, anabolic steroids, cannabis
    • these patients do not need referral and need reassurance
  • Gynaecomastia in older men – review medication as this is commonly a side effect of their treatment for another condition. E.g. spironolactone, digoxin, phenothiazines, epilim, PPIs, cimetidine, finasteride, Suggest stop the drug and review

​Referral

Referral Criteria

A 2WW Referral should be made

  • For male patients, aged 50 years and older with a unilateral, firm subareolar mass with or without nipple distortion or associated skin changes

Referral Instructions

Use the e-Referral Service to book the appointment, if no appointment available, click "defer to provider"

  • Priority: 2WW
  • Service: 2WW
  • Clinic type: 2WW Breast
  • Service: 2WW Breast Male - NDHCT - NDDH - RBZ

Referral Forms

Breast 2ww proforma

Supporting Information

Patient Information

Breast Cancer Care

Pathway Group

This guideline has been signed off by the Northern Locality on behalf of NEW Devon CCG.

Publication date: June 2017

Last updated: 24-06-2020

 

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