BMJ  2008;336:790 (12 April), doi:10.1136/bmj.39542.441539.3A

Letters

Gynaecomastia

Drugs and surgical concerns

The first 150 words of the full text of this article appear below.

Niewoehner and Schorer do not mention the long list of drugs which can be associated with gynaecomastia, especially in elderly patients.¹ A list (produced by the pharmacy of the Norfolk and Norwich University Hospital in 1993) has 69 drugs on it, including the commonly prescribed drugs allopurinol, amitriptyline, atenolol, ciprofloxacin, chlorpromazine, digoxin, enalapril, furosemide (frusemide), nifedipine, verapamil, and warfarin (the list is far too long to be included in a letter). In clinical practice, medication is the commonest cause of gynaecomastia in elderly patients.

One important point relating to surgical technique when removing excess breast tissue in young men should also be mentioned: excising all the abnormal breast tissue will result in an unsatisfactory cosmetic outcome as the enlarged breast will be replaced by a dent. A sufficient slice of breast tissue should be left to prevent this happening, and I have never encountered recurrent gynaecomastia despite adopting this technique . . . [Full text of this article]

¹ Norfolk and Norwich University Hospital, Norwich NR4 7UY

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Relevant Article

Gynaecomastia and breast cancer in men

Catherine B Niewoehner and Anna E Schorer
BMJ 2008 336: 709-713. [Extract] [Full Text] [PDF]