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Referral
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 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)
- 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 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 Form
Patient Information
Pathway Group
This guideline has been signed off on behalf of NHS Devon.
Publication date: June 2017
