Ultrasonography in gynecomastia diagnosis: Clinical experience

Abstract

Aim. To analyze the applicability of ultrasonography in gynecomastia diagnosis.
Materials and methods. The study included 119 males aged 18 to 74 years with complaints of a lump in the projection of the areola, and/or pain/discomfort in the breast gland area. All the patients underwent an ultrasound examination (US) of the breast. In 112 (94.05%) patients, US revealed changes typical of gynecomastia. All patients were divided into three age groups: 18–44 years (n = 99), 45–59 years (n = 15), 60–74 years (n = 5).
Results. Out of 112 cases, 97 and 15 were identified as gynecomastia and pseudogynecomastia, respectively. The highest incidence of gynecomastia was observed in the first age group, with peaks at 24–26 and 30–32 years. Gynecomastia was more often defined as bilateral (67%); unilateral gynecomastia was found in 21.6% and 11.4% of cases on the left and right breast, respectively. The average diameter of the glandular disc was not statistically different in the studied groups (p > 0.05, p = 0.5), while the thickness of the glandular layer was statistically significantly different and increased with age (p ≤ 0.05). The symptoms of true gynecomastia included: in 22 cases, pain and/or discomfort in the breast; in 37 cases, an increase in size; and in 38 cases, a combination of symptoms. Subcutaneous mastectomy on both sides was performed in 21 patients. Histologically, the fibrous stage of gynecomastia predominated in 85.7% of cases (n = 18), the intermediate stage accounted for 9.5% of cases (n = 2), and the flowering stage was noted in 4.8% of cases (n = 1). The US diagnostic efficacy was determined as follows: specificity 100%, accuracy 96.3%, and sensitivity 95.45%.
Conclusion. Ultrasound examination is an accessible, non-invasive, and safe diagnostic method for patients with suspected breast pathology.