Ultrasonic Diagnosis Of Gynecomastia And Discussion Of Its Pathogenetic Regularities

Background&Objective:Female breast diseases have recently attracted broad attention among the general public who has got medical popular science education. The female breast cancer has been widely concerned. However, the male breast diseases were neglected. Among them the gynecomastia is the most common one.Gynecomastia refers to the benign thickening of man’s breast gland tissue and the breast feminization. It occurs at any age group. According to epidemiological reports abroad, the prevalence rate of gynecomastia in the foreign countries reaches up to32%-65%. However, the number of retrospective summary and prospective study on diagnosis of male gynecomastia with ultrasonic method was little in China and very few in the medical publication in foreign countries. Furthermore, we also assume different clinical manifestation of this disease between the Chinese men and western Caucasian. Thus we need to create our own data to support the diagnoses for Chinese.The purpose of this study was to investigate the clinical value of ultrasonic diagnosis for the follow-up examination and monitor for gynecomastia. The author also discusses some Gynecomastia’s pathogenetic regularities explored on the candidate’s age, the year, the distribution of single and double sides etc by analysis the data of gynecomastia diagnosed by ultrasound.Methods:The medical records of178patients who took ultrasound examination in our hospital from Jan2005to Dec2013were selected for this case study. The patients’age was between3～98years old, the mean age and range is36.8±21.7years old. Among them,145people, with mean age and range is36.8±21.7years old, were confirmed by pathologically diagnosis, which is based on ultrasonic examination. This research analyses and summarises the distinguished features of ultrasonography appearances of these medical records. Then the ultrasound in diagnosis of gynecomastia was contrasted with the pathological conclution and clinical diagnosis.We computerize the data in microsoft excel for the following statistical analysis. The samples were divided5age groups, i.e. under19years group,20-39years,40-59years,60-79years,>80years group. While the patients were divided2groups:<30years ole and>30years old. Date also were divided2groups:20-39years old and else. Meanwhile, the patients were divided9group according to the year of diagnosis:year2005, year2006, year2007, year2008, year2009, year2010, year2011, year2012and year2013. Data was analyzed by SPSS19.0statistical software. Patients with the Chi-Square test analysis in the distribution of different ages and inspection date, with P<0.05as the useful statistically significant. Freguent distribution of gynecomastia was established to observe the incidence of single and double sides developed. Results:Among the145samples.95are of single gynecomastia (95/145,65.52%), within which57distribute on the left side, and38on the right side. There are50cases of bilateral gynecomastia (one developed from the left side to both sides). Ultrasonography are shown as different levels of thickening of gynecomastia, which length is about2.1-6.6cm, the average3.38±0.92cm, while the thickness is about0.50-2.90cm, the average0.78±0.30cm.Ultrasound showed the thickened gland proliferation below the nipple or around the areola was well defined and hypoechoic or slightly hyperechoic, not encapsulated, well circumscribed from the anterior subcutaneous adipose tissue and the posterior pectoral muscle, the internal echogenicity was either homogeneous or heterogenous, no strong echo calcification presented. CDFI showed that there was light vascularity in and around the gland.Conclusions:(145cases of gynecomastia ultrasonic ultrasonographic features were analysised. And the ultrasound in diagnosis of gynecomastia was contrasted with the pathological conclution and clinical diagnosis. While the distribution of the age and the check year and the incidence of single and double sides developed were statistical analysised. The conclusion is as follows:)1. Being an ideal inspection method, ultrasound has value in diagnosis and differential diagnosis of gynecomastia.2. Ultrasound has advantage of observe and evaluate the treatment result for gynecomastia.3. The study is the first to find that gynecomastia mostly occurred in the20-39age group.4. The study is the first to find that the incidence of gynecomastia has a growth trend in the past few years, especially during2013. 5. The study find that unilateral gynecomastia was most common (95/145,65.52%).