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Question 6#

Concerning gynecomastia, which of the following is true?

A. During senescence gynecomastia is usually unilateral
B. During puberty gynecomastia is usually bilateral
C. Is not associated with breast cancer except in Ehlers-Danlos patients
D. Is classified as per a three-grade system

Correct Answer is D

Comment:

In gynecomastia, the ductal structures of the male breast enlarge, elongate, and branch with a concomitant increase in epithelium. During puberty, the condition often is unilateral and typically occurs between ages 12 and 15. In contrast, senescent gynecomastia is usually bilateral. Gynecomastia generally does not predispose the male breast to cancer. However, the hypoandrogenic state of Klinefelter syndrome (XXY), in which gynecomastia is usually evident, is associated with an increased risk of breast cancer. Gynecomastia is graded based on the degree of breast enlargement, the position of the nipple with reference to the inframammary fold and the degree of breast ptosis and skin redundancy:

• Grade I: mild breast enlargement without skin redundancy.
• Grade IIa: moderate breast enlargement without skin redundancy.
•  Grade lib: moderate breast enlargement with skin redundancy.
• Grade 3: marked breast enlargement with skin redundancy and ptosis.