Drug-induced gynecomastia and gynecomastia due to long-term exposure to estrogen are believed by some to increase a patient's risk for breast cancer. However, numerous clinical studies have failed to show the relationship between breast cancer and gynecomastia. The only study which shows clear association between gynecomastia and male breast cancer is with Klinefelter syndrome; patients who have gynecomastia and Klinefelter syndrome are at about 50% increased risk of male breast cancer. Drug-induced gynecomastia is the second most common cause of gynecomastia. Significant studies have been conducted to research the effects of the drugs that cause gynecomastia; however, much additional work is required.
If the gynecomastia patient is not satisfied with an otherwise excellent surgical result or a clear history of abuse from having the condition is noted, therapy may be required, and the appropriate referral should be recommended. Resolving any severe overlying emotional issues produces a much higher satisfaction rate with the surgical outcome in these individuals.
The enhanced awareness of gynecomastia in men appears to parallel the interest in cosmetic procedure for men in general. Plastic surgical procedures in men continue to show a steady rise in the United States. Men had over 750,000 cosmetic procedures, 8% of the total in 2010, according to the American Society for Aesthetic Plastic Surgery. The number of cosmetic procedures for men has increased over 88% from 1997.
In general, the management of gynecomastia is not controversial; its typically benign nature and the indications for medical and surgical management are well established.