Up to seventy-five per cent of normal boys in pubertal stages 2 to 3 have unilateral or bilateral breast development. No definitive endocrine test has indicated the cause of this breast development but it is self-limited and usually transient. It is intensified by obesity and minimised to some degree by weight loss. It may last in some children for years and cause significant psychological distress during adolescence. Only occasionally is plastic surgery indicated.
Certain conditions, such as Klinefelter's syndrome and a variant of the androgen-resistance syndrome, are associated with gynaecomastia and respond best to surgical therapy. Thus, pathological conditions must be eliminated, usually by careful physical examination, before the diagnosis of adolescent gynaecomastia is made.
