Gynaecomastia is a breast manifestation of a systemic problem. Secondary care referral and investigation is not necessary in the vast majority of cases.<\/p>\n\n\n\n
Breast lumps in men (rather than generalised breast swelling), or other suspicious features such as nipple inversion, nipple discharge or distortion should be referred to the Breast Unit as USC \u2013 please see guidance on RefHelp Breast Lump page<\/a> and\/or RefHelp Nipple Symptoms page<\/a>.<\/p>\n\n\n\n The vast majority of referrals referred to EBU as men with breast lumps are found to have gynaecomastia. It is therefore recommended that in most cases where referral is being arranged, gynaecomastia bloods are arranged either prior to referral, or at point of referral. <\/p>\n\n\n\n However, if the clinical picture is clearly suggestive of a likely breast cancer then waiting for bloods should NOT delay referral.<\/strong><\/p>\n\n\n\n Published data has shown that transgender women have a higher risk of breast cancer compared to men, and transgender men have a lower risk of breast cancer compared to women. In transgender women the risk of breast cancer is associated with hormone treatment. In cases of gender reassignment, it is important to provide sensitive and clinically appropriate care depending on individual circumstances and considering any hormone therapy involved. (Scottish Referral Guidelines for Suspected Cancer July 2025)<\/em><\/p>\n\n\n\n Referrals to the Breast Unit for men with USC are triaged in the same way and to the same timescale as USC referrals to the Breast Unit for women are triaged.<\/strong><\/p>\n\n\n\n Gynaecomastia is common, may be unilateral and is due to an imbalance of sex hormones.<\/p>\n\n\n\n Causes include:<\/p>\n\n\n\n As per the <\/strong>SRGSC 2025 Gynaecomastia<\/strong><\/a> can be a feature of germ cell tumours. See below re examination and investigation to help rule out testicular cancer as a cause.<\/strong><\/p>\n\n\n\n Predisposing causes can be address in Primary Care, and do not need referral to Breast Unit<\/p>\n\n\n\n If no obvious cause is found then consider blood tests for:<\/p>\n\n\n\n In those with persistent swelling, not improved by addressing underlying factors, and who wish intervention then medication can be trialled:<\/p>\n\n\n\n This is an unlicensed indication. It is most useful for recent onset gynaecomastia and usually improves breast sensitivity. If prescription of a medication outwith its licensed indication is being considered, discussion with secondary care is an option, should this be felt necessary for the small number of patients who may benefit. <\/p>\n\n\n\n Surgical intervention is considered via the exceptional aesthetic referral pathway via Plastic Surgery.<\/p>\n\n\n\n Please see this helpful video from CfSD about Breast Lesions in Men<\/a><\/p>\n\n\n\n Men with a breast lump (with or without gynaecomastia) should be referred to Breast Clinic. Those with a clinically obvious lipoma may not need further investigation.<\/p>\n\n\n\n OY, LP & JB MAR 26<\/strong><\/p>\n\n\n\n <\/p>\n\n\n\n Urgent Referral<\/strong><\/p>\n\n\n\n <\/p>\n\n\n\n <\/p>\n\n\n\n Edinburgh, Midlothian and East Lothian Patients<\/strong><\/p>\n\n\n\n Western General Hospital >> General Surgery \u2013 Breast >> LI Breast Disease in Men (USC priority) Western General Hospital >> General Surgery \u2013 Breast >> LI Breast \u2013 Advice only<\/p>\n\n\n\n West Lothian Patients<\/strong><\/p>\n\n\n\n St John\u2019s Hospital >> General Surgery \u2013 Breast >> LI Breast Disease in Men (USC priority) St John\u2019s Hospital >> General Surgery \u2013 Breast >> LI Breast \u2013 Advice only<\/p>\n<\/div><\/div>\n\n\n\n See main page<\/p>\n\n\n\n Please see this helpful video from the CfSD re Breast Lesions in Men<\/a><\/p>\n<\/div><\/div>\n\n\n\n Scottish Referral Guidelines for Suspected Cancer 2025<\/a><\/p>\n\n\n\n CfSD Modernising Patient Pathways Programme: Gynaecomastia<\/a><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":" Gynaecomastia is a breast manifestation of a systemic problem. Secondary care referral and investigation is not necessary in the vast majority of cases. Breast lumps in men (rather than generalised breast swelling), or other suspicious features such as nipple inversion, nipple discharge or distortion should be referred to the Breast Unit as USC – please<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3744,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[51],"class_list":["post-3742","page","type-page","status-publish","hentry","category-breast-disease-in-men"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" Breast Disease in Men<\/a>","rttpg_excerpt":"Gynaecomastia is a breast manifestation of a systemic problem. Secondary care referral and investigation is not necessary in the vast majority of cases. Breast lumps in men (rather than generalised breast swelling), or other suspicious features such as nipple inversion, nipple discharge or distortion should be referred to the Breast Unit as USC – please","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3742","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=3742"}],"version-history":[{"count":17,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3742\/revisions"}],"predecessor-version":[{"id":27338,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3742\/revisions\/27338"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3744"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=3742"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=3742"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}Gynaecomastia<\/h4>\n\n\n\n
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Assessment<\/h4>\n\n\n\n
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Management<\/h4>\n\n\n\n
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Breast Lumps in Men<\/h4>\n\n\n\n
<\/ul>\n
Who to refer:<\/h4>\n\n\n\n
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Who not to refer:<\/h4>\n\n\n\n
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How to refer:<\/h4>\n\n\n\n
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Western General Hospital >> General Surgery \u2013 Breast >> LI Breast \u2013 Urgent<\/p>\n\n\n\n\n
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St John\u2019s Hospital >> General Surgery \u2013 Breast >> LI Breast \u2013 Urgent<\/p>\n\n\n\n\n